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WP0038640
EnvironmentalHealth
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FOREST LAKE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038640
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Entry Properties
Last modified
4/11/2019 9:31:24 AM
Creation date
4/11/2019 9:29:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038640
PE
4366
STREET_NUMBER
2820
Direction
W
STREET_NAME
FOREST LAKE
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00306031
ENTERED_DATE
8/9/2018 12:00:00 AM
SITE_LOCATION
2820 W FOREST LAKE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
AMeuangkhoth
Supplemental fields
CYEAR
2018
Tags
EHD - Public
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s� CHMN OF CUSTODY <br /> ENVIRONMENTAL -AGRICULTURAL Special www.fglinc.com <br /> Analytical Chemists ------- Customer Cop (2 of 3) <br /> r <br /> 3730:02106/2017 TEST DESCRIPTIOiti� - See Reverse side for Container. Preservative andampling int inmatirni <br /> Client: San Joa uin County EHD <br /> Address: San Jo in Co.Environmental Health Dep <br /> Water ality Division 3 <br /> Atm:Ra ey Estrada 14 <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 <br /> a <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada <br /> Project Name: <br /> Purchase Order Number: � IkT <br /> of, W <br /> Quote Number: ST 20160309-01 N <br /> o F- <br /> Sampler(s) U O Q <br /> x o <br /> Sampling Fee: Pickup Fee: n O O a <br /> Compositor Setup Date: / /_ Time: /_ z p 00 z <br /> o z Q F <br /> 0 <br /> Lab Number: STK 3-17919 0 C% E0. + U <br /> a°''� a. Via' h II <br /> Samp Location Description Date Time R s y y y <br /> Num Sampled Sampled a m m <br /> 1 G DW <br /> Rcmarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Dale: Time: <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 /> ti 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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