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WP0037527
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037527
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Entry Properties
Last modified
4/11/2019 9:24:27 AM
Creation date
4/11/2019 8:53:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037527
PE
4366
STREET_NUMBER
18124
Direction
S
STREET_NAME
HAZELHURST
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
24508049
ENTERED_DATE
10/27/2017 12:00:00 AM
SITE_LOCATION
18124 S HAZELHURST 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.fg com <br /> ENVIRONMENTAL AGRICULTURAL <br /> ` Field Copy (3 of 3) <br /> 35730:02/06/2017 TEST DESCRIPTION See Reverse side for Container.Preservative and Sampling information `4 <br /> Client: San Joaquin County EHD <br /> Address: San Joaquin Co.Environmental alth Dep 2' <br /> Water Quality Division a <br /> Attn:Rodney Estrada , <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 c <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada A <br /> Project Name: <br /> x 3 �, -• <br /> Purchase Order Number: w Q a ui <br /> Quote Number: ST 20160309-01 x Na <br /> $ 8 F o H <br /> Sampler(s) o 4n 00 a A <br /> 9 ¢c a x <br /> Sampling Fee: Pickup Fee: S 0.., O .o 5 p"O Q <br /> a� o a'� vr a" bz i <br /> Compositor Setup Date:_/_/_ Time:_/ rE z O c o z G z 0 Q F <br /> 0 <br /> Lab Number: STK 3-17919 0 a o 0 U x x x <br /> Samp Date Time �s a 5 .v =o c C, b x b b <br /> Location Description lu > o 5 0 ca <br /> Num Sampicd Sampled 1- a aq m O U <br /> 1 ) G DW <br /> r <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: Date: Time: Received By: Date: Fime: 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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