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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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5708
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3000 – Underground Injection Control Program
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PR0522753
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FIELD DOCUMENTS
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Last modified
11/19/2024 1:56:54 PM
Creation date
3/26/2020 1:25:53 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0522753
PE
3030
FACILITY_ID
FA0015509
FACILITY_NAME
ST FRANCIS MOTEL
STREET_NUMBER
5708
Direction
N
STREET_NAME
STATE ROUTE 99
City
STOCKTON
Zip
95212
APN
08703013
CURRENT_STATUS
01
SITE_LOCATION
5708 N HWY 99
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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GeoAnal tical Laboratories, Inc. Lab Report# <br /> y Regulatory Mes ONo CC: Mes 13No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 <br /> Modesto, CA 95351 Fax: (209) 572-0916 Regulator: <br /> est <br /> Phone: (PO k) x{73- 11 1 3 v tk—c yg) - Ni-q <br /> Client: H la l^%. '7-e-/—k 1 -6e,✓, L5 e-S CHAIN OF CUSTODY Fax: ( rot{ ) X173 — 1114 <br /> Address: V n.3oX -7 8,--�5 13 EDF 13 EDT Original To: u c C' V% z_ <br /> City 5 oc k-k�,�, , C ra Zip 45ZZ -7- 013-35 C] FIELD LOGS C.0 To: <br /> Project Ill ST �-,2A,JckS mo�k�1 s}�oc I <br /> Lab Use Only <br /> (Print Name c G~ <br /> Sampled By ✓1 = y - <br /> (Signature- Container 11 <br /> Sample type o 1 <br /> Sample ID Lab�► <br /> 1]fltC TnT1C Grab Comp Matri) Type Size <br /> Remark <br /> ✓� `� O '00 SJarnL x <br /> r <br /> Remarks <br /> Relinquished by(Signature) Date Time Received y Signat re) 'JL at, '1- <br /> _, r 14o I /-. ��a <br /> �l 1 1V1 I`fl <br /> Relinquished by(Signature) Date Time K eiv d b (Signature Date l Time <br /> Preservative: Matrix <br /> O40C©HCL0-Na0H0 NazSz03©-HNO3 O-H S 04 O-Other AM Drinking Water®Waste Water ® Hazardous Waste(Water) ©SoiUSolid <br /> Pump"Nuck Time Mileage <br /> Bailers _—_ 55 Gallon Drums_.__ r <br /> Approved By: <br /> r,rn�ro�on7������ ❑si�„a�re ❑SilvcrK�un ❑cwaK�sn ❑ri:,w�„�,�K�,n_ omrr <br />
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