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WP0041603
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041603
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Entry Properties
Last modified
12/21/2021 2:49:03 PM
Creation date
12/8/2021 9:53:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041603
PE
4366
STREET_NUMBER
25753
Direction
N
STREET_NAME
TULLY
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
02103033
ENTERED_DATE
1/12/2021 12:00:00 AM
SITE_LOCATION
25753 N TULLY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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--- -_— CHAIN OF CUSTODY <br /> .Now - Special www.fgUnc.com <br /> ENVIRONMENTAL <br /> Field Copy (3 of 3) <br /> IIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIII'IIII�II <br /> 730:0-2 00 ,01" TEST DESCRIPTIO' See Revcr,c •:r.lr tA, C'"nmincr. Pre,;er ative and Sampling information. <br /> Cli r. San Joaquin County EHD <br /> Add ess: San Joaquin Co.Environmental Health Dep <br /> Water QualityDivision I `' <br /> ' <br /> Attn:Rodney Estrada 3 a <br /> 1868 East Hazelton Ave. fI <br /> Stockton,CA 95205 3 <br /> Phone: (209)468-0331 Fax: W x <br /> Contact Person: Ro We Egroa A Q <br /> < 0 <br /> Project Name: a rn <br /> Purchase Order Number: 3 0 <br /> Quote Number: ST 20160309-01 o w ¢ a <br /> opo E <br /> Sampler(s) 0 z T O A <br /> b0 <br /> 0a r. Q 0 W <br /> Sampling Fee: Pickup Fee: c o a N o <br /> Compositor Setup Date:_/_/_ Time: / z O a Q z O z <br /> o <br /> o� ^ Cz u A E~ <br /> Lab Number: STK 3-17919 0 T ,��,. V <br /> Sam Date Time �a C> <br /> b =7 b <br /> p Location Description N o i 6 o ONkn n <br /> Num Sampled Sampled F, p„ W M,O U-� C7 c� isZ <br /> l G DW <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Daae: "Time: <br /> Received By: Datc: "Time: Received By: Date: Time: Received By: Date: Time: <br /> `V- <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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