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WP0037596
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EASTERN HEIGHTS
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21455
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037596
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Entry Properties
Last modified
6/20/2019 8:44:18 AM
Creation date
4/2/2019 9:32:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037596
PE
4366
STREET_NUMBER
21455
Direction
E
STREET_NAME
EASTERN HEIGHTS
STREET_TYPE
RD
City
LINDEN
Zip
95236-
APN
10529018
ENTERED_DATE
11/15/2017 12:00:00 AM
SITE_LOCATION
21455 E EASTERN HEIGHTS RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
AGooderham
Tags
EHD - Public
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CHAIN OF CUSTODY <br /> • www.fglinc.com AND ANALYSIS REQUEST DOCUMENT <br /> Client: San Joaquin Countv EHD Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Customer Number: 3017919 <br /> Address: Water Qualitv Division <br /> Attn: Michael Kith <br /> 1868 East Hazelton Ave. <br /> Phone: (209)468-3444 Fax: <br /> Email Address: mkith(o)..sicehd.eom <br /> Contact Person: Michael Kith <br /> Project Name: 21455 Eastern Heights-Linden ty o c <br /> Purchase Order Number: <br /> Quote Number: ddd V <br /> Rush Analysis: ❑ 5 Day❑4 Day❑3 Day E] 2 Day❑ 24 hour a <br /> Rush pre-approval by lab(initals): 4 2 RE <br /> Electronic Data Transfer: No State ❑Client Other { <br /> Sampler(s): ai Z <br /> Sampling Fee: Pickup Fee: t) <br /> E <br /> Compositor Setup Date: Time: <br /> Samp Location Description Date Time r$ v <br /> Num Sample(di SampledDW <br /> r— '-Fr— <br /> F-P1 Wellhead \ \ G 1 ��F�1-I ��� — ��I �� <br /> I -F-F-F-� F-7-7- -F- F-- <br /> !- �� �(-� �f � f���f I-II- f f--I- <br /> Remarks Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Tune: <br /> Replacement for STK1935845. `4\ \� ( �3/ <br /> No charge. \\ \ "J <br /> ARecc4d By: Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> Corporate Offlees&Laboratory Office R Laboratory Office&Laboratory Offloe 6 Laboratory Offlee b Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lindo Avenue 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 /> TEL:(805)392-2000 TEL:(209)942-0182 TEL:(530)343-5818 TEL:(805)783-2940 TEL:(559)734-9473 <br /> Env FAX:(605)525-4172/Ag FAX:(805)392-2063 FAX:(209)942-0423 FAX:(530)343-3807 FAX:(805)783-2912 FAX:(559)734-8436 <br /> CA ELAP Certification No,1573 CA ELAP Certification No.1563 CA ELAP Certification No.2670 CA ELAP Certification No.2775 CA ELAP Certification No.2810 <br />
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