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WP0041064
EnvironmentalHealth
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CAMPBELL
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041064
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Entry Properties
Last modified
11/17/2021 1:48:53 PM
Creation date
10/19/2020 3:10:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041064
PE
4366
STREET_NUMBER
14110
Direction
S
STREET_NAME
CAMPBELL
STREET_TYPE
AVE
City
ESCALON
Zip
95320-
APN
20731009
ENTERED_DATE
8/6/2020 12:00:00 AM
SITE_LOCATION
14110 S CAMPBELL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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Special ENVIRONMENTAL AGRICULTURAL <br /> <br />Analytical Chemists <br /> <br />CHAIN OF CUSTODY <br />www.fglinc.com <br />Laboratory Copy (1 or 1) <br />,1111 <br />-,-- <br />HI 111111 11., ,11111111111111 i 35731.02 Ili 2017 ITS! PI ti:-1.7 <br />1 <br />ti,. R: .:r.: Id: t ,,! ('-nt: ,ne' ,er\ an\ e and Simplini_ 1 <br />Client: San Joaquin County ElID <br />Address: San Joaquin Co. Environmenil Heal Dep <br />Water Quality Division li. i Atm: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />Phone:' (209)468-0331 Fax: <br />Contact Person: Rodney Estrada <br />Project Name: \\\\,tk4Cki(c,"\,..L. CZ) <br />Purchase Order Number: <br />Quote Number: ST 20160309-01 Method of Sampling: Composite(C) Grab(G) Type of Sample **SEE REVERSE SIDE** Potable(P) Non-Potable(NP) Ag Water(AgW) Bacti Type: Other(0) System(SYS) Source(SR) Waste( W Bacti Reason: RoutMe(ROUT) Repeat(RPT) Replace(RPL) Other(0) Special(SPL) = <br />(5 <br />a u co <br />9 ,...., <br />— < 4 0 <br />F-, > <br />g ] <br />Sampler(s) <br />Sampling <br />Compositor <br />Vi4i'aA (s' <br />Fee: Pickup Fee: <br />Setup Date: / / Time: / <br />Lab Number: STK oihn970 3-17919 <br />Num <br />Samp Date Location Description Sampled <br />Time <br />Sampled <br />() Travel Blank I I \())2A, \.\‘e oit 6 LBW -414t <br />I Ni,,,...\ Z...m... NkAsser,k0 ilibc.i WO ‘) G DW <br />Remarks: Relinquished Date: Time: Reli ' - ed Date: Time: Relinquished Date: Time: <br /> <br />ilidfrn lbibi <br />Flteived By: Date: Time: <br />( <br />Received By: Date: Time: Received By: Date: Time: <br />in 101 LI <br />Coroorate 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
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