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SR0086712_SSNL
EnvironmentalHealth
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2600 - Land Use Program
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SR0086712_SSNL
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Last modified
7/14/2023 2:39:13 PM
Creation date
6/16/2023 9:07:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0086712
PE
2602
FACILITY_NAME
GUZMAN PROPERTY
STREET_NUMBER
4011
Direction
E
STREET_NAME
WOODSON
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00516031
ENTERED_DATE
5/12/2023 12:00:00 AM
SITE_LOCATION
4011 E WOODSON RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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- CHAIN OF CUSTODY <br /> ENVIRONMENTALCHAIN <br /> ANALYSIS REQUEST DOCUMENT <br /> Lab_NuMb}g TEST DESCRIPTION AND ANALYSES REQUESTED <br /> F-- <br /> client: Live Oak GeoEnvironmental <br /> CuatWRCT Number: 3016608 <br /> Address: 407 W.Oak St. <br /> Lodi,CA 96240 <br /> Phone: (209)369-0375 Fax: <br /> F.mailAddress: abby@logelodi.com g <br /> Contact Person: Abby Racco Q $ <br /> Project Name: Guzman,4011 E. Woodson Rd., Aeampo tl <br /> Furthest Order Number: a e m _ <br /> Quote Number: <br /> Sampler(s): v Li— 2 v <br /> Sampling Fee: Pickup Fec: ` w Or <br /> c o �n rn <br /> m2 m Y v V� L <br /> Compositor Setup Date: Time: �, v E E:a fc V <br /> Samp Location Description Datc Timc E t x z {] <br /> Num Sampled Sampled z a cin rpn a yr o Z <br /> 1 Domestic Well 3f(123 E[,3lDsV, G 4 PIG P CW SRC O X X <br /> Remarks Relinquished Da Timc: Relinquished Date: Time: Relinquished Date: Time: <br /> 311A is -,:,eo&, <br /> o <br /> Receive [ te: Time: Recei ed 8 fe: Time: Received By: Date: Time: <br /> Corporate Offices A Laboratory Office a Leborato Office&Laboratory Field Oiflce <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lindo Avenue "Salle.California <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 TEL:559!734-9473 <br /> TEL:8051392-2000 TEL:2091942-0182 TEL:5301343.5618 Mobile:559!737-2399 <br /> FAX:8051525-4172 FAX7 209!942-0423 FAX:5301343-3807 FAX:559!734-8435 <br /> CA NELAP Certi6caVan No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />
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