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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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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GeoAnalytical Laboratories, Inc. Lab Report# <br /> Regulatory Yes [3 No CC: DYes E3 No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 <br /> �.�. Modesto, CA 95351 Fax: (209) 572-0916 Regulator: 1�4 ��' /^ �+"'y <br /> Phone: C11�) y(✓ — 3 y S Li <br /> Client: 5_?e 7� P/L/ G '/1 CHAIN OF CUSTODY Fax: ( ) <br /> Address: G' y S Z- 0 EDF 13 EDT Original To: <br /> City zip D FIELD LOGS C.0 To: <br /> Project ID Lab Use Only <br /> (Print Name) <br /> Sampled By -s C_ •✓ G /�v , .e �. <br /> Q y :. <br /> (Signature) G �� Container U <br /> Sample type Lab ID#Sample ID <br /> Date Time Grab Comp Matrixp Type Size a <br /> ' 'F ,�t,� t / L L C�4 w Remarks <br /> Remarks ) <br /> 0A1 <br /> N; /h S�✓u c 7",a A)_ O <br /> Relinquis �[ �Snat e) �te <br /> Time Receiv y(Sig ture) ! Date Time <br /> Relinquish by(Signature) Time Receive y(Signature) Date rime <br /> Preservative: Matrix <br /> O4°CO HCLONaOHO NazSz03©-HNO3 O-H P 04 O-Other • Drinking Water®Waste Water ® Hazardous Waste(Water)©Soil/Solid <br /> Pump Truck Time Mileage <br /> Bailers 55 Gallon Drums 0 <br /> Approved By: <br />
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