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WP0041962
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041962
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Entry Properties
Last modified
12/21/2021 2:45:41 PM
Creation date
12/21/2021 2:08:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041962
PE
4380
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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ENVIRONMENTAL — AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />www.fgUnc.com <br />'Meld Copy (3 of 3) <br />Corporate Offices & Laboratory <br />`• <br />II II 730:02/06'20 17 <br />TEST DESCRIPTION - See Revere: ids I -i urtainer. I' ,. ..uive and Sampling information <br />Office & Laboratory <br />r -- <br />Cl' nt: San Joaquin County ERD <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Ad rens: San Joaquin Co. Environmental Health Dep <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Water Quality Division <br />a <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />N <br />$ <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-0331 Fax: <br />tj W <br />a <br />Contact Person: Rodney Estrada t <br />A <br />co <br />d <br />� <br />Project Name: �� �, 0 k_ !. - 1 1. i. <br />�w <br />V) <br />Purchase Order Number: <br />Quote Number: ST 20160309-01 <br />o <br />c. W <br />T <br />w <br />0. <br />L <br />z <br />, <br />F <br />0 <br />F <br />A <br />Sampler(s)o <br />U <br />V <br />p <br />K <br />°' <br />Sampling Fee: Pickup Fee: <br />Compositor Setup Date: _/_/_ Time: _/_ <br />R N <br />O <br />z <br />� <br />p <br />p <br />Ix U <br />w cNd <br />o z <br />U <br />cE M <br />c z <br />x <br />.d z <br />w <br />N <br />aU+ <br />A <br />x <br />E <br />x <br />Lab Number: STK 3-17919 <br />o rn <br />d o <br />ii <br />v <br />Samp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />E~ <br />a� <br />m <br />M O <br />U <br />c7 r <br />u a <br />w <br />❑ <br />G <br />DW <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Datc: Time: <br />Relinquished Date: time: <br />Rcceiv ed By: Date: Time: <br />Received By: Date: Time: <br />Received By: Datr: I inc: <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />
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