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SR0077423
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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SR0077423
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Entry Properties
Last modified
9/30/2019 9:02:10 AM
Creation date
9/24/2019 11:30:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0077423
PE
4378
STREET_NUMBER
21301
Direction
S
STREET_NAME
SAN JOSE
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
20928021
ENTERED_DATE
5/9/2017 12:00:00 AM
SITE_LOCATION
21301 S SAN JOSE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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CHMN OF CUSTODY <br /> -ENVIRONMENTAL M- L AGRICULTURAL Speci..,l www.fglinc.com <br /> Analytical Chernists Field Copy (3 of 3) <br /> 35730:02/06/2017 TES1 DEQ 'RIPTION - See Reverse side for Container. Preservative and Sampling :nlorl, ttion <br /> Client: San Joaquin Cout:ty E;,D <br /> Address: San Joaquin Co.Enviro'mental Health Dep <br /> Water Quality Division 3 <br /> Atm: Rodney Estrada a <br /> 1868 East Hazelton Avt 3 <br /> Stockton,CA 95205 =° <br /> n. <br /> Phone: (209)468-0331 Fax: <br /> � w 3 <br /> Contact Person: Rodney Estrada v Q ¢ 2 aF <br /> C7 W o <br /> Project Name: <br /> Purchase Order Number: <br /> Quote Number: ST 20160309-01 <br /> W <br /> N Eo F <br /> W y F 00 <br /> Sampler(s) o 5� z > O Q <br /> .o° W <br /> Sampling Fee: Pickup Fee: <br /> c C <br /> Compositor Setup Date: / /_ Time: / E z O o z Ca <br /> Lab Number: STK 3-17919 'o a a@ U N= x x <br /> a a, <br /> Samp location Description Date Time � Q � � R r o N y� ? C' y � <br /> Num Sampled Sampled F n w w O U - c7 <br /> I G DW 1 l.l.l <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: "Time: <br /> Received By: Dais: 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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