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WP0043009
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043009
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Entry Properties
Last modified
3/15/2023 4:49:00 PM
Creation date
1/10/2023 10:40:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043009
PE
4366
STREET_NUMBER
23595
Direction
N
STREET_NAME
MACKVILLE
STREET_TYPE
RD
City
CLEMENTS
Zip
95227-
APN
01922034
ENTERED_DATE
2/25/2022 12:00:00 AM
SITE_LOCATION
23595 N MACKVILLE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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CHA[H OF CUSTODY <br /> ENVIRONMENTAL FGL AGRICULTURAL Special www.fgUne.c,om <br /> Analytical Chemists } Field Copy (3 of 3) <br /> II�IIIIII�III�IIIIIIII'II�II IIIIII'l1IIIIIIIIIIN ; 35730:02/06x2017 TEST DESCRIPTION ; See Reverse side for Container. Preservatii,e and Sampling information-FT <br /> h. <br /> Clie -- I I I <br /> nt: San Joagtti County EHD - TT <br /> N,,I,1,.,.. '. „ L,.„uif'`j rF,,ir1 14 94 6-1 III . <br /> WaterQuality Division t' - <br /> Attn: Rodney Estrada <br /> 1868 Gast Ilazclton Aye. 3 <br /> Stockton,CA 95205 z_ <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rqdney EstradaCa <br /> Project Name: i�-f? +° ” lt7 x ro — <br /> Purchase Order Number: 3 a Uj <br /> Quote Number: ST 20160309-01 <br /> o a E o H <br /> n W p^ y F <br /> O <br /> Sampler(s) E vWi z > O <br /> O <br /> * m ❑ d 0 x <br /> W <br /> Sampling Fee: Pickup Fee: <br /> y O rJ 'c� v cryo `M .,'z y E <br /> Compositor Setup Date:_/ /_ Time:_/_ `E E z O o ,c z O w A <br /> Lab Number: STK 3-17919 0 a a U x <br /> E <br /> Date Time <br /> Samp Location Description <br /> Num Sampled Sampled <br /> I G DW <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: Date: Time: Received By: Date: Time: Received By: Date: Time: <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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