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WP0041961
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041961
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Entry Properties
Last modified
12/21/2021 6:40:53 PM
Creation date
12/8/2021 9:55:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041961
PE
4366
STREET_NUMBER
14000
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
02104302
ENTERED_DATE
4/23/2021 12:00:00 AM
SITE_LOCATION
14000 E COLLIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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F-M = CI LAIN OF CUSTODY <br /> ENVIRONMENTAL AGRICULTURAL <br /> Special www.fgUnc.com <br /> A:ialytical Chemists Laboratory'Copy,t1 of 3) <br /> 111 JillR <br /> 35731:08102/2021 TEST DESCRIPTION See Reverse side for Container. Pies ervatc.e and npling infoimation <br /> Client: San Joae n County EHD A <br /> Address: Sail Joaq �Co. Environmental Health Dep <br /> `'Vater Qt iity Division <br /> Attn: Mi0ael Kith 3 �•` <br /> 1868 EastHazelton Ave. <br /> StocktonlA 95205 <br /> CL <br /> Phone: (209)468-3444 Fax: <br /> c? w 3 <br /> Contact Person: Michael Kith Q ¢ a <br /> Project Name: \4013 y r t V <br /> Purchase Order Number: c <br /> 1M1�L i > > f� 0 <br /> Quote Number: <br /> E <br /> Sampler(s) E w z Q <br /> f_ <br /> " * L O <br /> p x... <br /> a o o <br /> Sampling Fee: Pickup Fee: <br /> Compositor Setup Date: / ! Time: / E a z p a w <br /> E o vz v <br /> Lab Number: STK 3-17919 0 a a ro > <br /> Samp Date Time ; '� a <br /> Num Location Description Sampled Sampled F' p <br /> I �� N{�'�1 �u `'�� l C >3 G DW Sub-3 <br /> Remarks: Relinquished Date: Time: to shed Date: Time: Relinquished Date: Time: <br /> j d';/` 13"�J d /70Z <br /> Received By: Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> Corporate Offices&Laboratory ratory 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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