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WP0040961
EnvironmentalHealth
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4300 - Water Well Program
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WP0040961
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Entry Properties
Last modified
4/27/2022 10:56:53 AM
Creation date
4/27/2022 10:53:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0040961
PE
4380
STREET_NUMBER
18933
Direction
N
STREET_NAME
DE VRIES
STREET_TYPE
RD
City
LODI
Zip
95242-
APN
01304010
ENTERED_DATE
7/10/2020 12:00:00 AM
SITE_LOCATION
18933 N DE VRIES RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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Client Name: FGL Environmental, Inc. <br />Contact: Cindy Aguirre <br />Address: 853 Corporation Street <br />Santa Paula, CA 93060 <br />Report Date: 06 -Apr -2022 <br />ADO <br />BABCOCK Laboratories, Inc. <br />The Standard of 'Excellence for Over 100 1 ears <br />Analytical Report: Page 5 of 5 <br />Project Name: No Project <br />Project Number: STK2233978 (3017919) <br />Work Order Number: C2C3237 <br />Received on Ice (Y/N): Yes <br />Babcock Laboratories, Inc. <br />Subcontract Chain of Custody <br />CLIENT DETAILS: <br />Client: FGL Environmental <br />Address: 85; (nr�oratinn Streel <br />Santa Paula. CA 93060 <br />Phone: (805)392-2000 Fax: (805)525-417? <br />Project: STK2233978 (3017919) <br />Ctntlacl Pusan: Cindy Aguirre <br />REPORT INFORMATION: <br />Rush Analysis: ❑5 days ❑4 days ❑: days ❑2 days ❑24 hours <br />Electronic Data Transfer: No <br />If yes, To: State_ Client 01hor <br />Temp: 2 °C <br />REMARKS: Sent From FGL Lab ST <br />location <br />P (951) 653-3351 <br />0 <br />P.O. Box 432 <br />6100 Quail Valley Court <br />F (951) 653-1662 <br />EPA No. CA00102 <br />Riverside, CA 92502.0432 <br />Riverside, CA 92507-0704 <br />www.babcocklabs.com <br />NELAP No. OR4035 <br />O <br />E <br />u <br />a <br />_ <br />3ya <br />c <br />O- <br />0 <br />5 V <br />R U <br />IQ� <br />r <br />SAMPLING: <br />Satupler(s) <br />6cc <br />aJ <br />L <br />p C <br />N <br />` <br />p <br />Naseem Ahmed <br />C <br />5 <br />2 <br />LJ <br />N <br />_ <br />6 <br />a <br />n <br />y <br />x v? <br />azi <br />SE <br />u$ u <br />e <br />0 <br />0 <br />1ip <br />C0 <br />ii <br />O rn <br />rc y I <br />Z <br />e <br />a <br />2 <br />z <br />H <br />H,u3 <br />x <br />` <br />_ <br />Samp!e Lomlioa0wription Date Time <br />Numltcr Smnplcrl S "n i <br />r <br />cL <br />m <br />In <br />Wellhead 3'23+22 1133 <br />G <br />I DW <br />X <br />oh IL <br />Y <br />C202370 <br />a <br />Pl <br />t <br />Rc'd: 03,25.2022 09:30 <br />V■J r� <br />CUSTODY: J (�03� <br />Relinquished hy: Date: �� Time: Relinquished by: Dana: Time: <br />Received by: Dari jt `1`Time: � Received by: Datc: )t% I <br />mailing <br />location <br />P (951) 653-3351 <br />CA ELAP No. 2698 <br />P.O. Box 432 <br />6100 Quail Valley Court <br />F (951) 653-1662 <br />EPA No. CA00102 <br />Riverside, CA 92502.0432 <br />Riverside, CA 92507-0704 <br />www.babcocklabs.com <br />NELAP No. OR4035 <br />
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