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WP0040157
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040157
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Entry Properties
Last modified
3/16/2020 8:54:47 PM
Creation date
3/16/2020 4:18:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040157
PE
4380
STREET_NUMBER
15910
Direction
N
STREET_NAME
DAVIS
STREET_TYPE
RD
City
LODI
Zip
95242-
APN
02703001
ENTERED_DATE
10/7/2019 12:00:00 AM
SITE_LOCATION
15910 N DAVIS RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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l.� <br /> -_ Hmri OF CUSTODY <br /> 'EMIXONMENTAL - . RAL Special www.fgUnc.com <br /> Analytical Chernists Field Copy (3 of 3) <br /> 35730:02/06/2017 TEST DESCRIPTION See Reverse side for Container,Preservative and Sampling information <br /> Client: San Joaquin County EHD <br /> Address: San Joaquin Co.Environmental Health Dep <br /> Water Quality Division 3 a <br /> Attn: Rodney Estrada <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 a <br /> Phone: (209)468-0331 Fax: <br /> a <br /> oq <br /> Contact Person: Rodney Estrada Q d 2 <br /> � x <br /> Project Name: <br /> Purchase Order Number: _ ua <br /> Quote Number: ST 20160309-01 <br /> K W a ayEi 00 <br /> Sampler(s) o w z T � Q <br /> U _ v) P' <br /> Sampling Fee: Pickup Fee: C <br /> C N M N <br /> Compositor Setup Date: / / Time: / E a z p U °�z °Z co E <br /> o ' cz <br /> 0 <br /> Lab Number: STK 3-17919 o w acu E a a a <br /> 'o o °? F. <br /> Samp Date Time �s & =o c E b x <br /> Num Location Description Sam Sampled ' ' ° d <br /> Sampled P F- a m w O V - <br /> 1 G DW <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: 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 /> 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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