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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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SJGOV\sballwahn
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EHD - Public
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GeoAnalytical Laboratories, Inc. Lab Report# � <br /> Regulatory EMS E3No CC. Dyes 0 No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 <br /> Modesto, CA 95351 Fax: (209)572-0916 Regulator: <br /> Phone: (7-0 ri) 33q - S—1 ci I <br /> Client: S4e Ae n l7. Muir I CHAIN OF CUSTODY Fax: ( ) <br /> Address: ��c Gi h-t� �iLa�r`�^?h i2 i s 13 EDF 13 EDT Original To: <br /> City L'i0oAr,(1/1iQ (' Zip (f e) 0 FIELD LOGS C.0 To: <br /> Lab Use Only <br /> Project ID STF� r • ' �.�-�. c � �� �'' � y <br /> (Print Name) <br /> Sampled By S Cl Y r tic <br /> (Signature) ' ) Container Q' y > <br /> Sample typez Lab ID# L <br /> Date Time Sample ID Type size <br /> Comp i / Remark,, W <br /> p 1 , ``°M <br /> 7- <br /> Remarks LR t <br /> Date Time Receive y(:ii nature) Date Time <br /> Relinquished by(Signature) ! g <br /> Relinquished b% (Signature) DateTi Re ei ed by(Signature) Dat• Time <br /> Preservative. Matrix <br /> 0 40C8HCL&Na0H0Na2S2030-HNO3 <br /> 0-HO4Oa 0-Other Drinking Water®Waste Water ® Hazardous Waste(Water) ©Soil/Solid <br /> Pump Truck Time r7 hY j Nfileage r <br /> Bailers ;;Gallon Drums 0 ' <br /> Approved By: '. �a`J I <br />
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