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WP0039617
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039617
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Entry Properties
Last modified
12/15/2020 2:21:47 PM
Creation date
12/15/2020 2:18:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039617
PE
4380
STREET_NUMBER
24173
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00740058
ENTERED_DATE
5/15/2019 12:00:00 AM
SITE_LOCATION
24173 N ELLIOTT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\fgarciaruiz
Tags
EHD - Public
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ML CHmri OF CUSTODY <br /> ENVIRONMENTALSpecial www.fgUnc.com <br /> Analytical Chemists 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 a <br /> Attn:Rodney Estrada <br /> 1868 East Hazelton Ave. ro <br /> Stockton,CA 95205 o <br /> Phone: (209)468-0331 Fax: w x <br /> Contact Person: Rodney Estrada <br /> w � x <br /> C7 W o <br /> Project Name: v) <br /> Purchase Order Number: <br /> Quote Number: ST 20160309-01 <br /> a w a E H o E- <br /> Sampler(s) <br /> U * O a O <br /> a 0 <br /> 'Z3 U) a0 $ xF <br /> Sampling Fee: Pickup Fee: .5 oa 0 <br /> Compositor Setup Date: /_/_ Time:_/_ z O a o z z w A H <br /> Lab Number: STK 3-17919d s.aU aMc x <br /> w, -4 <br /> Date Time <br /> = ca' °Samp Location Description ' o <br /> Num Sampled Sample N' M0 FN x°II <br /> o pb <br /> U� <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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