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COMPLIANCE INFO_2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0514138
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COMPLIANCE INFO_2019
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Last modified
6/7/2021 10:49:37 AM
Creation date
6/23/2020 11:02:03 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0514138
PE
2250
FACILITY_ID
FA0010034
FACILITY_NAME
PNP Stockton #80
STREET_NUMBER
3927
Direction
E
STREET_NAME
CLARK
STREET_TYPE
DR
City
STOCKTON
Zip
95215
APN
17917109
CURRENT_STATUS
01
SITE_LOCATION
3927 E CLARK DR
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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* Lab Report# <br /> GeoAnalytical Laboratories, Inc. l-g3i 48 <br /> Regulatory DYes 13No CC: 13Yes 13No <br /> 2300 Maryann Drive Phone: (209)669-0100 <br /> Turlock, CA 95381 Fax: (209) 593-2212 Regulator: <br /> Phone: (209 ) 669-0100 <br /> :tient: San Joaquin County EHD CHAIN OF CUSTODY Fax: ( ) <br /> address: 1868 East Hazelton Avenue 13EDF 13EDT Original To: info@geo-nalyticallab.com <br /> :ity Stockton, CA Zip 95205 13 FIELD LOGS C.0 To: <br /> Project ID PNP Stockton#80 <br /> ( � Lab Use Only <br /> Print Name) <br /> Sampled By Lydia Baker W <br /> (Signature) o '" <br /> w <br /> Container c L <br /> Sample t <br /> Date Time type Sample ID z o Lab ID# 4 <br /> Grab Comp MatrixType I—Size m p, <br /> 10-11-19 14:54 ✓ Absorbent at Drain Building#1/Bin Cl 4 oz 1 1 ✓ -03 1 <br /> `CA Title 22 Bioassay, Screening Test, Fathead Minnow. Please Waive Fish Holding Period. <br /> Relinquished by( <br /> Si azure) Date- Time Received by tgnature) Date Time <br /> 7r <br /> lz�p TI-1 <br /> 1,14 <br /> Relinquished by(Stn ure) I}ate' Time Recei d igna Dale i'irnr <br /> Preservative: <br /> Matrix <br /> 0 4°C*HCL&Na0H8 Na2S203 0-HNO3 10-H P 04 40ther AD Drinking Water S Waste Water tW Hazardous Waste(Water)IDSoit/Solid <br /> Mileag <br /> Bailers 55 Gallon Drums Pump Tuck Time e_ <br /> Iftom ww-nim psundrd ❑surer Rush ElGoldRush ElPlaunumitush 00ther Approved By: <br /> 8/13 <br />
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