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WP0040569
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040569
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Entry Properties
Last modified
5/29/2020 8:46:13 AM
Creation date
5/29/2020 8:36:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040569
PE
4366
STREET_NUMBER
4353
Direction
W
STREET_NAME
CALIFORNIA
City
TRACY
Zip
95304-
APN
21318053
ENTERED_DATE
2/26/2020 12:00:00 AM
SITE_LOCATION
4353 W CALIFORNIA
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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CHAIN OF CUSTODY <br /> Fm— <br /> ENVIRONMENTAL AGRICULTURAL Special www.fglinc.com <br /> Analytical Chemists Field Copy (3 of 3) <br /> 35731:02/06/2017 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 a <br /> Attn:Rodney Estrada a4 <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 c <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada A <br /> 4. 7 <br /> Project Name: C7 vWi h ro <br /> Purchase Order Number: a <br /> Quote Number: ST 20160309-01 <br /> E <br /> Sampler(s) o vWi z > O <br /> U <br /> O O D ii O <br /> Sampling Fee: Pickup Fee: <br /> C <br /> Compositor Setup Date:_/_/_ Time: /_ �, z O a a <br /> Lab Number: STK 3-17919 0a o ro .. WO <br /> 0 0 H ao � <br /> A ' <br /> Saznp Location Description Date Time � T o UV,06 a c <br /> Num Sampled Sampled F„ R Gq Gq O W, <br /> 0 Travel Blank G LBW 1 4 <br /> 1 G DW 4 <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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