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WP0042002
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042002
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Entry Properties
Last modified
1/27/2022 8:34:27 AM
Creation date
1/27/2022 8:26:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042002
PE
4380
STREET_NUMBER
22584
Direction
N
STREET_NAME
DUSTIN
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00705016
ENTERED_DATE
5/6/2021 12:00:00 AM
SITE_LOCATION
22584 N DUSTIN 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 />Special CHMN OF CUSTODY <br />P www.fgUnc.com <br />Customer Copy (2 of 3) <br />6 <br />Corporate Offices & Laboratory Office & Laboratory <br />853 Corporation Street 2500 Stagecoach Road <br />Santa Paula, CA 93060 Stockton, CA 95215 <br />Phone: (805) 392-2000 Phone: (209) 942-0182 <br />Env Fax: (805) 525-4172 /Ag Fax: (805) 392-2063 Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Undo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />35730:02/06/2017 <br />TEST DESCRIPTION - See Reverse side for Container, Preservative and Sampling information <br />Client: San Joaquin County EHD <br />Address: San Joaquin Co. Environmental Heaith Dep <br />Water Quality Division <br />a <br />Atm: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />a <br />Phone: (209)468-0331 Fax: <br />w <br />x <br />Contact Person: Rodney Estrada <br />Project Name: L L� ' 1�l rt .:. <br />�°n <br />Purchase Order Number: t^_ .-. ;, I j. • i ; �]`%. I <br />3 <br />a <br />Quote Number: ST 20160309-01 <br />0 <br />¢ <br />>'a <br />o <br />w <br />a <br />z <br />F <br />t <br />A <br />Sampler(s) <br />p,*. <br />•�( �> c c'a l-1 G 11, 'l- � <br />U <br />iF <br />h <br />O <br />. a <br />o <br />.a <br />Sampling Fee: Pickup Fee: <br />C P• <br />d tYt <br />2 <br />W <br />Compositor Setup Date: / / Time: / <br />Ei <br />c <br />z <br />O <br />y <br />= z <br />O <br />z <br />M <br />0 <br />cz <br />iy <br />A <br />F <br />Lab Number: STK 3-17919 <br />0 <br />d <br />V) <br />o <br />a <br />a <br />a <br />M <br />'� °' <br />q <br />o <br />a <br />° <br />alu <br />„ <br />F II <br />a <br />a <br />Samp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />a <br />gq <br />M O <br />U :�! <br />I <br />G <br />DW <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Dare: Time: Relinquished <br />Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Corporate Offices & Laboratory Office & Laboratory <br />853 Corporation Street 2500 Stagecoach Road <br />Santa Paula, CA 93060 Stockton, CA 95215 <br />Phone: (805) 392-2000 Phone: (209) 942-0182 <br />Env Fax: (805) 525-4172 /Ag Fax: (805) 392-2063 Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Undo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />
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