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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HILDRETH
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10285
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3000 – Underground Injection Control Program
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PR0523204
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Last modified
1/31/2020 5:31:08 PM
Creation date
1/31/2020 4:15:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0523204
PE
3030
FACILITY_ID
FA0015585
FACILITY_NAME
PENNINGTON, SUNG HI
STREET_NUMBER
10285
Direction
N
STREET_NAME
HILDRETH
STREET_TYPE
RD
City
STOCKTON
Zip
95212
APN
08653026
CURRENT_STATUS
02
SITE_LOCATION
10285 N HILDRETH RD
P_LOCATION
01
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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GeoAnYeses ONalytical Laboratories, Inc. Lab Report E3N - C <br /> Regulatory o CC: DYes QNo <br /> 1405 Kansas Avenue Phone: (209)572-0900 <br /> Modesto, CA 95351 Fax: (209)572-0916 Regulator: <br /> Phone: ( > L/7 ` &/ <br /> Chew: CHAIN� �/T J2 _ CHAIN OF CUSTODY Fax: ( ) <br /> Address: 13 EDF 13 EDT Original To: C/N <br /> S City r5 G/� r Zip 13 FIELD LOGS C.0 To: <br /> Project ID 102XS- JJ. (� Lab Use Only <br /> (Print Name) a <br /> Sampled Byy <br /> (Signature) Container w <br /> Sample type Sample ID z # ` <br /> �` Date Time <br /> Grab Comp Malri Typc Size i Remark-, <br /> �3— 5 w� c,IF <br /> � x x <br /> i"1ll <br /> (0 <br /> v_ <br /> (A� <br /> ,y <br /> .f\ <br /> j �•.t, <br /> is Remarks <br /> e` Relinquished by(Signature) p Dale Time eccived by(Signature) Dale Time <br /> � 1 � <br /> Relinquished by(Signature) Dale Time Received by(Signature) Date Time <br /> Preservat Matrix <br /> 0 40C©HCLO-NaOHo Na2S203 0-HNOa O-H SO, 0-Other------Q Drinking Water®Waste Water ® Hazardous Waste(Water)©SoilfSolid <br /> Pump Truck TimeV / Mileage <br /> �Ilailcrs 55 Gallon Drums p 0 / L <br /> am <br /> Turnnnd Tim ❑ <br /> e S ❑Silver Rirsh ❑fold Hush ❑Platinum Rush ❑Other tandard Approved By: <br /> _.___ <br />
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