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WP0042272
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042272
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Entry Properties
Last modified
10/27/2021 2:09:17 PM
Creation date
10/27/2021 2:01:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042272
PE
4380
STREET_NUMBER
10897
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00714029
ENTERED_DATE
7/12/2021 12:00:00 AM
SITE_LOCATION
10897 E COLLIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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g�L <br />ENVIRONMENTAL <br />AGRICULTURAL <br />Analytical Chemists <br />Client: San Joaquin County EHD <br />Special Cion OF CUSTODY <br />P www.fgUnc.com <br />Laboratory Copy (1 of 3) <br />1111111111111111111111111111111111111111111111111111111111 <br />35731:08/02/2021 <br />TEST DESCRIPTION See Reverse side for Container, Preservative and Sampling information <br />Client: San Joaquin County EHD <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />3 <br />a <br />Attn: Michael Kith <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />=` <br />y <br />Phone: (209)468-3444 Fax: <br />Contact Person: Michael Kith <br />,,Q /J <br />Project Name: /O X `7 � 6G. ' i e e %TW Ae,'P" <br />b <br />0 <br />v° <br />0. <br />Purchase Order Number: <br />y7, <br />C <br />Quote Number: <br />> <br />O <br />a <br />Sampler(s)o <br />L <br />Sampling Fee: Pickup Fee: <br />5 <br />° <br />¢ <br />Compositor Setup Date: / /_ Time: / <br />o <br />K <br />v') <br />z <br />iE <br />O <br />Q <br />z <br />a <br />0. <br />W <br />M> <br />Lab Number: STK �3� 3-17919 <br />CL <br />S`iO1l' <br />Num <br />Location Description <br />Date <br />Sampled <br />Time <br />Sampled <br />y <br />o <br />a <br />H <br />M <br />L <br />o <br />;z <br />a, <br />w <br />= p <br />V) It <br />I <br />iLlOf� j <br />•i3t�� <br />�, <br />G <br />I DW <br />Sub -3 <br />Remarks: <br />Relinquished Date: Time: <br />Relingt(ished Uate: Time: <br />Relinquished Date: Time: <br />17 <br />R By: Date: Time: <br />Received By: ate Time: <br />Received By: Date: Time: <br />� 1.700 <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />
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