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WP0040342
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040342
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Entry Properties
Last modified
11/2/2020 10:50:14 AM
Creation date
11/2/2020 10:24:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040342
PE
4366
STREET_NUMBER
16464
Direction
N
STREET_NAME
FOX
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
05120007
ENTERED_DATE
12/2/2019 12:00:00 AM
SITE_LOCATION
16464 N FOX RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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- -_ CHAiri OF CUSTODY <br /> • — - AGRICULTURAL Special www.fgUnc.com <br /> Customer Copy (2 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 /> Atm:Rodney Estrada a <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 a <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada Q <br /> Project Name: V,� 64 V) cG <br /> x <br /> Purchase Order Number: L)C.hL �a�6� � w <br /> Quote Number: ST 20160309-01 N E <br /> a w a <br /> Sampler(s) o z > O <br /> ca 2 <br /> Sampling Fee: Pickup Fee: <br /> Compositor Setup Date:_! / Time: /_ N E z O Q <br /> G <br /> O <br /> Lab Number: STK 3-17919 0 12 ii 0. v p <br /> lamp Date Timea '� Q <br /> Num Location Description Sampled Sampled F: a ai m O W a <br /> 0 Travel Blank G LBW 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 /> - �. S �10 <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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