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WP0042339
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4300 - Water Well Program
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WP0042339
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Entry Properties
Last modified
9/19/2022 4:14:12 PM
Creation date
2/17/2022 2:39:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042339
PE
4370
STREET_NUMBER
20911
Direction
E
STREET_NAME
BUSHKA
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
20509022
ENTERED_DATE
7/26/2021 12:00:00 AM
SITE_LOCATION
20911 E BUSHKA RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Tags
EHD - Public
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CHAIN OF CUSTODY <br /> ML ENVIRONMENTAL -- AGRICULTURAL <br /> Special www.fgUnc.com <br /> Analytical Chernists <br /> Laboratory Copy (1 of 3) <br /> IIIIIIIIIIIIIIIIIIII���II�IIIIIIIIIIIIIIIIII�IIIIIIIIIII�II 35731:08/02/2021 TEST DESCRIPTION - See Reverse side for Container,Preservative and Sampling information <br /> Client: San Joaquin County EHD <br /> Address: San Joaquin Co. Environmental Health Dep <br /> Water Quality Division j <br /> Attc: Michael Kith <br /> a <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 <br /> a <br /> Phone: (209)468-3444 Fax: <br /> t_7 fi1 3 <br /> Contact Person: Michael Kith v Q <br /> Project Name: <br /> Purchase Order Number: U w <br /> W 3 c <br /> Q 5. a <br /> Quote Number: o a <br /> E U <br /> Sampler(s) w z a Q <br /> Sampling Fee: Pickup Fee: ❑ a <br /> Compositor Setup Date:_/_/ Time: /_ E & z p x o W <br /> &n E <br /> Lab!Number: STK � ` 3-17919 0 Q0 a_ a � �> <br /> Sam Date Time � <br /> Num Location Description Sampled Sampled t~ a oa° ca O a <br /> 1 G DW Sub-3 <br /> Remarks: Relinquishe \L\\Date: Time: ReIm wished Date: Time: Relinquished Date: Time: <br /> �\L\ lib U C"" v ��v <br /> Received Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> I� o1z 6 clb IZ 16121 1-Im <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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