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WP0042889
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COTTAGE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042889
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Entry Properties
Last modified
2/22/2024 4:11:39 PM
Creation date
6/10/2022 1:43:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042889
PE
4378
STREET_NUMBER
16000
Direction
S
STREET_NAME
COTTAGE
STREET_TYPE
AVE
City
MANTECA
Zip
95336-
APN
20837010
ENTERED_DATE
1/10/2022 12:00:00 AM
SITE_LOCATION
16000 S COTTAGE AVE
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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CHMN OF CUSTODY <br /> ENVIRONMENTAL AORICULTURAL Special www.rgUnc.com <br /> Laboratory Copy (1 of 2) <br /> 35730:01/01/2024 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 a <br /> Attn:Scott Sanglaang n, <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 <br /> Phone: (209)468-3452 Fax: <br /> Contact Person: Scott Sangalang <br /> V 7 <br /> Project Name: `� In to O j-�(n �(C• °' <br /> Purchase Order Number: <br /> Quote Number: ST 20160309-01 <br /> A. W a <br /> Sampler(s) 0 z <,� Q <br /> * p: ��cn 44 <br /> a0 t' -' BCH <br /> Sampling Fee: Pickup Fee: o <br /> Compositor Setup Date: 1 I Time: / E z O a; =z OCd <br /> v� 8 ov U gM w� A H <br /> Lab Number: STK 3-17919 o w PIN <br /> a .• a s '-' <br /> c <br /> Samp Location Description Date Time T c 5'(4 N a <br /> Num _^n Sampled Sampled E., C., M M O V O c-1 <br /> 1 ��c--���`��✓�J S G DW <br /> Remarks: <br /> Relinquished Date: q P Time: Relinquished Date: Time: Relinquished Date: Time: <br /> W Q .-��� <br /> ( -� ' �' ,;>� ^asp c"1c� rfi tS r co �� <br /> Received(B�y: Date: `Time: Received By: Date: Time: Received By: Date: Time:2—I.!3 9 <br /> OC-0 <br /> Ets ?-05-'w n D� C QL-)E- L <br /> Comorate Offices&Laboratory Office S 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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