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SR0083481
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4200/4300 - Liquid Waste/Water Well Permits
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SR0083481
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Entry Properties
Last modified
12/7/2021 11:48:43 AM
Creation date
5/20/2021 1:07:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
SR0083481
PE
4201
STREET_NUMBER
76
Direction
W
STREET_NAME
BOWMAN
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231
APN
19326019
ENTERED_DATE
3/30/2021 12:00:00 AM
SITE_LOCATION
76 W BOWMAN RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHIntern
Tags
EHD - Public
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A & L WESTERN LABORATORIES, INC. <br /> T. 1311 Woodland Ave. #1. 9 Modesto, California 95351 • Phone 209-529,4080 <br /> CHAIN OF CUSTODY <br /> Client C' �`� )/� {/ �1��'✓ /�� Tf/��� Phone <br /> Address CC to: <br /> Zip <br /> Signature of person authorizing work <br /> under terms stated below' %z., ! <br /> `Net 30 days. All accounts past due will be subject to interest charges of 1.5% per month. <br /> 'Hazardous materials are the property of the client. The client is responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID A No ANALYSIS <br /> 5�!<1,41 of <br /> Con. <br /> �((� <br /> SAMP-'�D BY: ' ature): ers G <br /> REMARKS <br /> sample <br /> type Sample Location <br /> Date Time Grab can,. <br /> r 7-- <br /> f <br /> rrs;, >< GThiP x x 5A Ir r zpy✓J �i/ n %A �/ <br /> i <br /> '7-R <br /> -r- A. 4 a/vi <br /> t i'r'k ` V ! <br /> Relin#sed by(si �i 0): Date, Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(sigf ature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />
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