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WP0037679
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037679
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Entry Properties
Last modified
11/19/2024 3:48:23 PM
Creation date
1/9/2019 10:32:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037679
PE
4366
STREET_NUMBER
26702
Direction
E
STREET_NAME
STATE ROUTE 12
City
WALLACE
Zip
95227-
APN
02322007
ENTERED_DATE
12/11/2017 12:00:00 AM
SITE_LOCATION
26702 E HWY 12
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 /> ENVIRONMENTAL — - Special www.fgUnc.com <br /> Analytical Chemists Customer Copy (2 of 3) <br /> 35730:02/06/2017 TEST DESCRIPTION - See Reverse side for Container,Preservative and Sampling information <br /> Client: 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. u <br /> Stockton,CA 95205 <br /> Phone: (209)468-0331 Fax: o: <br /> Contact Person: Rodney Estrada <br /> Project Name: C7 h <br /> Purchase Order Number: U w ua <br /> Quote Number: ST 20160309-01 " x N <br /> Sampler(s) U w w A <br /> °x <br /> a ¢`^ <br /> Sampling Fee: Pickup Fee: a° O o,O <br /> a W� 0 <br /> Compositor Setup Date:_/_/ Time:_/ E z O Q =z <br /> �n E; c o g x ii; A E <br /> Lab Number: STK 3-17919 0 iii U a a o <br /> o vim. H P4 G C E H ii <br /> rim <br /> lu <br /> Date Time 0 � = [c °x Location Description Sam led Sam led °' ' O co e° o N P P E- a ao a1 O U c7 c� u,_: is. iJ <br /> G DW 1 1,1,1 ?� Jt, <br /> Rematk Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received 13N: Date: Time: Received By: Date: Time: Received By: 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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