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WP0037642
EnvironmentalHealth
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MICKE GROVE
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11374
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037642
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Entry Properties
Last modified
9/29/2018 7:50:11 PM
Creation date
8/23/2018 1:10:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037642
PE
4370
STREET_NUMBER
11374
Direction
N
STREET_NAME
MICKE GROVE
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
05914003
ENTERED_DATE
11/28/2017 12:00:00 AM
SITE_LOCATION
11374 N MICKE GROVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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DAfonskaia
Tags
EHD - Public
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= CHMN OF CUSTODY <br /> -' AGRICULTURAL Special www.fgUnc.com <br /> Analytical Chemists <br /> Customer Citipy (2 of 3) <br /> 111111111111111111111111111111 IN 35730:02/06/2017 t; TEST DESCRIPTION See Reverse side for Container, Preservativelnd Sampling information <br /> Client: Sat(Joaquin County EHD <br /> Address: San)oaquin Co. Environmental Health Dep <br /> Water Quality Division a <br /> Attn: Rodney Estrada a <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada <br /> ,�` <br /> Project Name: � ! �� I V• 6 r b L/,* k -1b <br /> Purchase Order Number: <br /> Quote Number: ST 20160309-01 W ¢ <br /> o F <br /> Sampler(s) E w z > O 0 Q <br /> * Cn a Q <br /> ou 0. O 'Evac ¢O `� W <br /> Sampling Fee: Pickup Fee: g , o= ?•" aF- <br /> Compositor Setup Date: / / Time:_/_ M o z p n = Z ;, •- ro E <br /> E <br /> Lab Number: STK 3-17919 0 a a <br /> Samp Date Time -S 2 s <br /> c E :2 b <br /> Location Description o <br /> Num Sampled Sampled N <br /> 1 G DW 1 LLL <br /> Remarks: Relinquished Date: Time: Relinquished Dmc: Time: Relinquished Date: Time: <br /> Recck CLI li- Date: Time: Rcceived B}: Date: Time: Received BN': Date: Time: <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E. Lindo 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 San Luis Obispo,CA 93401 Visalia,CA 93291 <br /> Phone:(805)392-2000 Phone:(209)942-0182 Phone:(530)343-5818 Phone:(805)783-2940 Phone: (559)734-9473 <br /> Env Fax: (805)525-4172/Ag Fax:(805)392-2063 Fax: (209)942-0423 Fax: (530)343-3807 Fax:(805)783-2912 Fax: (559)734-8435 <br />
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