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WP0040344
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040344
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Entry Properties
Last modified
12/15/2020 2:55:27 PM
Creation date
12/15/2020 2:52:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040344
PE
4366
STREET_NUMBER
12966
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240-
APN
06325031
ENTERED_DATE
12/2/2019 12:00:00 AM
SITE_LOCATION
12966 KETTLEMAN LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\fgarciaruiz
Tags
EHD - Public
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- CHAIN OF CUSTODY <br /> . , Special www.fgUnc.com <br /> Analytical Chemists Customer Copy (2 of 3) <br /> 1111111111111 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 3 <br /> Attn:Rodney Estrada <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 a <br /> Phone: (209)468-0331 Fax: <br /> `) _ <br /> Contact Person: Rodney Estrada Q <br /> Project Name: ' � <br /> Purchase Order Number: L v l • I �' Uw y <br /> ;5w <br /> ¢ x <br /> Quote Number: ST 20160309-01 <br /> E <br /> Sampler(s) E vWi z > O <br /> Sampling Fee: Pickup Fee: S a O .o' O <br /> a <br /> Compositor Setup Date: / / Time: / E r, z O ECon- <br /> Lab <br /> v) oQ <br /> Number: STK 3-17919 0 C'n iZ o. p <br /> 0 <br /> Samp Date Time = Q Q E <br /> Num Location Description Sampled Sampled F a° m M,O w <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 /> 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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