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WP0040474
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040474
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Entry Properties
Last modified
3/16/2020 8:49:07 PM
Creation date
3/16/2020 4:27:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040474
PE
4380
STREET_NUMBER
10462
Direction
E
STREET_NAME
SOUTHLAND
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
20807004
ENTERED_DATE
1/28/2020 12:00:00 AM
SITE_LOCATION
10462 E SOUTHLAND RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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IML CI MN OF CUSTODY <br /> • — Special www.fgUnc.com <br /> Analytical Chemists M_—: 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 /> Atm: Rodney Estrada p; <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 <br /> a <br /> Phone: (209)468-0331 Fax: w 3 <br /> Contact Person: Rodney Estrada Q ¢ 2 <br /> Project Name: <br /> Purchase Order Number: <br /> Quote Number: ST 20160309-01 <br /> 0. W a a��i t"' � <br /> Sampler(s) 0 vWi z > O A <br /> U * ?? V) a O <br /> a * O O C� ¢O ° W <br /> Sampling Fee: Pickup Fee: <br /> c <br /> a v 'u a cNy M O b z y E <br /> Compositor Setup Date: /_/ Time: /_ E z O c •o z c Ca <br /> 0 <br /> Lab Number: STK 3-17919 0 a a m U x x x <br /> Samp Location Description Date Time ;, o 5 15 o N o n <br /> Num Sampled Sampled F ,y w pa O U c7 N is. <br /> I 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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