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WP0042898
EnvironmentalHealth
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4300 - Water Well Program
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WP0042898
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Entry Properties
Last modified
4/1/2022 9:34:40 AM
Creation date
4/1/2022 9:33:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042898
PE
4380
STREET_NUMBER
11136
Direction
E
STREET_NAME
FAIRCHILD
STREET_TYPE
RD
City
STOCKTON
Zip
95215-
APN
08911023
ENTERED_DATE
1/12/2022 12:00:00 AM
SITE_LOCATION
11136 E FAIRCHILD RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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CHAU1 OF CUSTODY <br />Special www fglinc.com <br />LaboratoWy Copy (1 of 3) <br />-11 <br />35730:02/OG/20�7 CGS f llLSCRIPTION -Sec Rcccrse side forCuntainer. Prcu:ivaW11111 rill I IN 111111 milli 0111111111 five and Samplin ' infunnatiun <br />Client;. %an Joaquin Count), EHD I i <br />AddresS: San Joaquin Co. environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada 1868 EastHazelton Ave.AL <br />Stockton, CA 95205 <br />Phone: (209)468-0331 Fax: <br />tv <br />w <br />3^ <br />r4 <br />P4 <br />I)ate:lTime: <br />it <br />Re ce' B <br />L <br />al <br />te: Tim <br />R ved By: <br />Date: Time: <br />alis <br />Contact Person: Rodney Estrada l_ <br />AA�• La <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />A <br />h <br />O0 <br />0/ <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Phone: (559) 7349473 <br />Fax: (559) 734-8435 <br />Project Name: t(acct <br />55,- 5'(0 <br />LU <br />Purchase Order Number. <br />Quote Number: ST 20160309-01 <br />E <br />W' <br />iii <br />4 <br />y <br />p <br />a <br />o <br />o <br />F <br />Sampler(s) <br />l-.raw�2 (rLCa r�t <br />t0 <br />y <br />t ,^, <br />o <br />Sampling Fee: Pickup Fee: <br />* <br />oo <br />eN <br />Qo <br />Compositor Setup Date: / Time: / <br />Eo <br />z <br />p <br />o4 "y <br />u z <br />O <br />d <br />—1 - -- <br />M <br />o <br />E <br />rn <br />a <br />K <br />ey <br />cZ <br />Y'2 <br />5Z <br />w� <br />= <br />x <br />E - <br />x <br />Lab Number. STK 3-17919 <br />Samp <br />Location Description <br />Date <br />Sampled <br />Time <br />Sampled <br />a <br />>r <br />•n <br />-$ <br />E <br />cc <br />u E <br />Z OR <br />o <br />" o•Num <br />fl <br />= <br />a <br />O <br />V. <br />G <br />DW <br />1 <br />1.1,1 <br />6, 63 <br />l l ► <br />l l : i <br />Remarks: <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />Phone: (805) 392-2000 <br />Env Fax: (805) 525-4172 / Ag Fax: ( <br />805) 392-2063 <br />Office 8 Laboratory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />Phone: (209) 942-0182 <br />Fax: (209) 942-0423 <br />ate: Time: <br />Relinquish <br />Time: <br />Relinquished <br />Date: me: <br />I)ate:lTime: <br />it <br />Re ce' B <br />L <br />al <br />te: Tim <br />R ved By: <br />Date: Time: <br />alis <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalla, CA 93291 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Phone: (559) 7349473 <br />Fax: (559) 734-8435 <br />
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