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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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Special CHMN OF CUSTODY <br /> ENVIRONMENTAL-- , P www.fglinc.com <br /> Analytical Chemists t Fielt Copy 3 of 3) <br /> 3573 8/02/2021 TEST DESCRIPTION See Reverse side ey Conta# r. Pie, native and Sampling information <br /> f <br /> Client: San Joaquin County E13D <br /> Address: San Joaquin Co.Environmental Health Dep <br /> Water Quality Division ? a <br />,k Atm: Michael Kith 3 <br /> 18f8 East Hazelton Ave. <br /> Stockton,CA 95205 a <br /> 4 Phone: (209)468-3444 Fax: ua y a <br /> Contact Person: Michael Kith A d <br /> 4` <br /> Project Name: C a rn T <br /> Purchase Order Number: <br /> Quote Number: <br /> a <br /> Sampler(s) o z �? <br /> 0 p o <br /> Sampling Fee: Pickup Fee: Pr �, o <br /> a c Q <br /> Compositor Setup Date: /_/_ Time: /_ p z O �, w <br /> Lab Number: STK 3-17919 0 VA 5 a <br /> 0 04� 0 CL <br /> Samp Date Time <br /> Num Location Description Sampled Sampled F 0 pq p <br /> 1 G DW Sub-3 <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> 0 <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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