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WP0039538
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JACK TONE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039538
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Entry Properties
Last modified
3/5/2021 12:57:47 PM
Creation date
3/5/2021 12:26:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039538
PE
4380
STREET_NUMBER
23811
Direction
S
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366-
APN
22817034
ENTERED_DATE
4/23/2019 12:00:00 AM
SITE_LOCATION
23811 S JACK TONE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Tags
EHD - Public
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CHAIN OF CUSTODY <br /> Lots]M 1K111 II&A.1 Special www.fgUnc.com <br /> Customer Copy (2 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 3 a <br /> Attn: Rodney Estrada a <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 <br /> n. <br /> Phone: (209)468-0331 Fax: x <br /> Contact Person: Rodney Estrada ¢ 2 <br /> Project Name: <br /> x <br /> Purchase Order Number: �gn^ `�. �S�p� 3 ° <br /> oq Lcl <br /> Quote Number: ST 20160309-01 N w ¢ ' a <br /> a W is 0 � o0o Q <br /> Sampler(s) (, ' G_ o z > O <br /> Sampling Fee: Pickup Fee: c ao O o a O <br /> CN M <br /> Compositor Setup Date: / / Time: / E fl z p z <br /> z <br /> Lab Number: STK 3-17919 0 a a U x <br /> - <br /> 5amp Date Time So =o <br /> Num Location Description Sampled Sampled ° ° <br /> P P � F- a w =O v-- t7 <br /> 1 G DW <br />!I 1r <br /> f <br /> f <br /> i <br /> F <br /> c <br /> f <br /> 1 <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> �.� A GJ1Onto <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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