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WP0041716
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COLLIER
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4103
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041716
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Entry Properties
Last modified
5/2/2023 4:27:39 PM
Creation date
2/13/2023 1:51:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041716
PE
4366
STREET_NUMBER
4103
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00539046
ENTERED_DATE
2/19/2021 12:00:00 AM
SITE_LOCATION
4103 E COLLIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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CHMN OF CUSTODY <br /> ENVIRONMENTAL AGRICULTURAL Special www.fgltrtc.com <br /> Analytical Chernists Laboratory Copy (1 of 3) <br /> III�III I�I VIII I II�IIIIIIIIII� II III�III 35731:08/02/2021 TEST DESCRIPTION - See Reverse side for Container,Preservative and Sampling information <br /> Client: San Joaquin County END <br /> Address: San Joaquin Co.Environmental Health Dep <br /> Water Quality Division C ,j <br /> Atm:Michael Kith 1,f� Lk S <br /> 1868 East Hazelton Ave. \�1 3 E <br /> �w <br /> Stockton,CA 95205 iO <br /> n <br /> z <br /> Phone: (209)468-3444 Fax: <br /> Contact Person: Michael KithI r y < <br /> Project Name: ��D, Cot" " " � y m y t— <br /> Purchase Order Number: A`k /'A. j S 2 n U w 3 v^: ? e <br /> Quote Number: t 'o rX `�'• U <br /> o E <br /> Sampler(s) f I � r o ti Z >, Ca <br /> a <br /> eo o Oa rain g <br /> Sampling Fee: Pickup Fee: ° w Z o m <br /> 6 C <br /> Compositor Setup Date: �T/ime: / y z O a c W <br /> Lab Number: $TK 2 3-17919 `o a r A a m j <br /> o u a F nO pL. <br /> Samp Location Description Dale Time v r o m$ E <br /> Num Sampled Sampled � F w Ln m O h a <br /> G DW Sub-3 <br /> Remarks: Relinquished Date: Time: uished D��: Time: Relinquished Date: Time: <br /> �, d�.(�?oz /7440 <br /> R ed By: Date: Time: Received By: Dqte: Time: Received By: Dam: Time: <br /> �i/Yo23 /055 0>jO IM?3 17,00 <br /> Coroorate 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)7349473 <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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