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WP0037519
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037519
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Entry Properties
Last modified
12/27/2018 8:44:31 AM
Creation date
12/26/2018 1:10:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037519
PE
4366
STREET_NUMBER
9502
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
01719024
ENTERED_DATE
10/26/2017 12:00:00 AM
SITE_LOCATION
9502 E PELTIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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DAfonskaia
Tags
EHD - Public
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CHmri OF CUSTODY <br /> . — Special } www.fgUnc.com <br /> Analytical Chemists CusU)mer Copy (2 of 3) <br /> 11111111111111111111111111111 IN 35730:02/x!2017 TEST DESCRIPTION - See Reverse side for Container, enervative and Sampling information <br /> C';ent: San Joaquin County EHD <br /> Address: San Joaquin Co.Environmental Health Dep <br /> Water Quality Division a <br /> Attn:Rodney Estrada <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 <br /> c. <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada A <br /> Project Name: co <br /> Purchase Order Number: U u ua <br /> Quote Number: ST 20160309-01 <br /> E o F <br /> Sampler(s) U h z O A <br /> * yr P4 <br /> °o x <br /> Sampling Fee: Pickup Fee: .5 o <br /> d N O '7 <br /> Compositor Setup Date:_/_/ Time:_/_ E �, z O a z O <br /> o,. cz <br /> Lab Number: STK 3-17919 o w ii� T d O a a o a <br /> Samp Date Time n 'V- <br /> = <br /> Location Description , o N aCi n <br /> Num Sampled Sampled F a m m O V <br /> l G Dye <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Recek,ed By:, Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> I c1 <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Undo 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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