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WP0041043
EnvironmentalHealth
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HOMESTEAD
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24169
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041043
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Entry Properties
Last modified
12/27/2021 11:33:12 AM
Creation date
6/14/2021 4:35:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041043
PE
4366
STREET_NUMBER
24169
Direction
N
STREET_NAME
HOMESTEAD
STREET_TYPE
LN
City
ACAMPO
Zip
95220-
APN
00740062
ENTERED_DATE
7/30/2020 12:00:00 AM
SITE_LOCATION
24169 N HOMESTEAD LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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EIYVF€'ZONMENTAL AGRICULTURAL <br />Analytical Chemists <br />CHAIl`l OF CUSTODY <br />Special www.jglinc.com <br />Customer Copy (2 of 3) <br />Corporate Offices & Laboratory <br />35730:02/06/2017 <br />TEST DESCRIPTION See Reverse side for Container, Preservative and Sampling information <br />Client: San Joaquin County EHD ar <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Address: San Joaquin Co. Environmeetal Health Dep <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />c <br />Phone: (209)468-0331 Fax: <br />w <br />x <br />Contact Person: Rodney Estrada ; <br />d <br />Project Name: <br />Purchase Order Number: P, r IA 414 0 <br />Quote Number: ST 20160309-01 <br />w <br />a <br />oo <br />A <br />Sampler(s) �I <br />�' <br />U° <br />0 <br />p <br />2,2 <br />t <br />Sampling Fee: Pickup Fee: <br />c <br />a <br />Compositor Setup Date: _J_/ Time: _/_ <br />a <br />0w <br />?? <br />c <br />6 <br />z <br />v <br />ry <br />O <br />T <br />u;'� <br />� o <br />� <br />M <br />z <br />oz <br />w <br />SMO <br />„ <br />gz <br />a <br />bz <br />6 �- <br />H II <br />o <br />E <br />i - <br />n <br />Lab Number: STK 3-17919 <br />Samp <br />Location Description <br />Date <br />Time <br />� <br />" <br />Q <br />' <br />2 <br />° <br />u <br />M <br />0 <br />M <br />w° o <br />° <br />c o <br />x <br />° <br />Num <br />Sampled <br />P <br />Sampled <br />P <br />[-� <br />a <br />m <br />m 0 <br />U <br />c7 N <br />- <br />iw <br />i1 <br />G <br />DW <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished Dain: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />LI ++ <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />
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