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WP0043573
EnvironmentalHealth
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ELLIOTT
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043573
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Entry Properties
Last modified
3/13/2025 10:50:43 AM
Creation date
2/17/2023 4:08:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043573
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
26860
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
GALT
Zip
95632-
APN
00722015
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
26860 N ELLIOTT RD GALT 95632-
Tags
EHD - Public
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�62 <br /> CHAIN OF CUSTODY <br /> www.fgline.com com - <br /> �glinoANDANALYSIS hEQUES7'D6CU1LfENT <br /> Client; San Joaquin County EHD Lab Number TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Custoiner .Number: 3017919 <br /> Address: Water Quality Division — <br /> Attn: Steven Shih <br /> 1868 Eat Hazelton Ave. <br /> Phone (209)468-9850 Fax. <br /> Email Address: SShlh@s190v.6rg F T <br /> Contact Person, Steven Shlh _ -13 <br /> Project Name: IL <br /> w4- � �Ln�C� lva, /r ica 3 <br /> Purchase Order Number: /,0& CA <br /> Quote Number 0 ? <br /> Rush Analysis: 5 Day 4 Day❑3 Day[—] 2 bay❑ 24 hour U ¢� �` fi D a v <br /> Rush pre-approval by lab(initals): <br /> Electronic Bata Transfer No❑ 41 <br /> State Client Other: 6] ?Ja g';- — n <br /> + <br /> Sampler( CM <br /> of <br /> J 51 <br /> $ c <br /> Sampling Fee: Pickup Fee: g dL <br /> Compositor Setup Date: Tune: b q <br /> Samp Location Description Date Time I—C sL fn ui^ J\ <br /> Num Sampled Sampled C <br /> l Gl��- toz3 0 2Z0 67 ) <br /> FF <br /> Remarks Relinquished Date: Time: Relinquished Date. Time: Relinquished Date Time: <br /> � Z• f l( <br /> ReOi� Date: Time: Received Ey: Date: Time: Received 13y: Date: Time: <br /> �L411 i t <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lindo Avenue 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 /> TEL:(806)392-2000 TEL:(209)942-0182 TEL:(530)343-5818 TEL:(805)783-2940 TEL:(559)734-9473 <br /> Env FAX:(805)525-4172/Ag FAX:(805)392-2063 FAX:(209)942-0423 PAX:(530)343-3807 FAX:(805)783-2912 FAX!(559)734-8435 <br /> CA ELAP Certification No.1573 CA ELAP Certification No.1563 CA ELAP Certification No.2670 CA ELAP Certification No.2775 CA ELAP Certification No.2810 <br />
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