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WP0036516
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4200/4300 - Liquid Waste/Water Well Permits
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WP0036516
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Entry Properties
Last modified
3/8/2019 5:04:34 PM
Creation date
3/8/2019 4:21:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0036516
PE
4366
STREET_NUMBER
23555
Direction
N
STREET_NAME
GRAHAM
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00727049
ENTERED_DATE
1/30/2017 12:00:00 AM
SITE_LOCATION
23555 N GRAHAM RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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AMeuangkhoth
Tags
EHD - Public
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CHAIN OF CUSTODY <br /> Special www.fglinc.com <br /> L�VIRONMENTAL-- AGRICULTURAL <br /> Analytical Chemists <br /> j Fief-t'Copy (3 of 3) <br /> "� $ <br /> r° <br /> 1,11 1 35730:02/06/2017'. TEST DESCRIPTION - See Reverse side for Container. Preserx a, :e and Sampling information <br /> Client: 1an Joaquin County EHD <br /> Address:fater <br /> d' n Joaquin Co. Environmental Health Dep <br /> Quality Division <br /> m:Rodney Estrada '141 <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 =° <br /> a <br /> Phone: (209)468-0331 Fax: w x <br /> Contact Person: Rodney Estrada n. Q <br /> Project Name: � � �} 1"' R v� <br /> Purchase Order Number: <br /> Quote Number: ST 20160309-01 ¢ <br /> 0 F <br /> Sampler(s) o V) IVz T O A <br /> o & .5� QO W <br /> Sampling Fee: Pickup Fee: g a y � a N a <br /> r4zC7 N rn <br /> Compositor Setup Date: / / Time: / E z p = 1 O b z E <br /> --- vt i3 n cZ c z w Q r <br /> Lab Number: STK 3-17919 0 C p a M U <br /> Samp Date Time <br /> Num Location Description Sampled Sampled " ° ° ° ° <br /> ( <br /> 1 G Dye' <br /> i <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Timc: <br /> Received By: 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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