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WP0041895
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041895
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Entry Properties
Last modified
12/21/2021 6:06:39 PM
Creation date
12/8/2021 9:54:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041895
PE
4366
STREET_NUMBER
5823
STREET_NAME
FAIRLANE
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00527015
ENTERED_DATE
4/2/2021 12:00:00 AM
SITE_LOCATION
5823 FAIRLANE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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CHmri OF CUSTODY <br /> AGRICULTURAL Special www.fglinc.com <br /> tAnalytical Chemists Laborattry Cory (1 of 3) <br /> IIIIII1f I 3: :311:02/06/2("17 TEST DESCRIPTION - See Reverse siJ: I�,i (' `, ainer. Prest!rvalk and Sampling informati n <br /> I IIIIIII�III��hill II VIII I'lll�IIID VIII IIII VIII IIII IIII <br /> Chet San Joaquin County EHD rt <br /> Addrjss: San Joaquin Co. Environmental Health Dep <br /> Water Quality Division <br /> Attn:Rodney Estrada 3 <br /> 1868 East Hazelton Ave. 3 <br /> 'Stockton,CA 95205 <br /> o. <br /> Phone: (209)468-0331 Fax: <br /> ix <br /> Contact Person: Rodney Estrada ¢ e <br /> U <br /> Project Name: A �AJf I � C7 on <br /> Purchase Order Number: , L, et s-w a _ w <br /> Quote Number: ST 201603-01 0 <br /> E o00 <br /> F- <br /> Sampler(s) ( r n G U *= N 0 O <br /> �1,�a S�`' l!f 4'�"�Ey ��j✓ iw �o O •�vii Q o ° w <br /> Sampling Fee: Pickup Fee: <br /> Compositor Setup Date:_I_/_ Time: /_ zo p o �'Z 2 O <br /> 05z w <br /> Lab Number: STK -1, '2Z� 3-17919 O a a ;W) c c <br /> Samp Date FTime -S <br /> Location Description <br /> Num Sampled led <br /> F. p, gp pq O V-� C7 cv ii,_: iI u. <br /> 1 L1 o G DW 1 1,1.1 <br /> Remarks: Relinquished Date: Time: hed Da}e: Time: Relinquished Date: Time: <br /> G i �c 'D/;/�J )boaNI) (j 61 <br /> RZed By: Date: Time: Received By: Da e: Time: Re ived 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/Aq 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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