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WP0043695
EnvironmentalHealth
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120 (STATE ROUTE 120)
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12870
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043695
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Entry Properties
Last modified
11/19/2024 4:01:51 PM
Creation date
6/20/2023 8:41:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043695
PE
4370
STREET_NUMBER
12870
Direction
E
STREET_NAME
STATE ROUTE 120
City
MANTECA
Zip
95336-
APN
22804005
ENTERED_DATE
8/31/2022 12:00:00 AM
SITE_LOCATION
12870 E HWY 120
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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CHMN OF CUSTODY <br /> Special www.fglnc.comENVI. <br /> I--- Asialytical Ow-mists Laboratory Copy (1 of 2) <br /> 111111 Milli 11111111 UNIMMIE 35731:04/03/2023 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 <br /> Attn:Scott Sanglaang <br /> 1868 East Hazelton Ave. tJ"�� <br /> Stockton,CA 95205 v- 3 c <br /> Phone: (209)468-3452 Fax: w ;; a4 <br /> Contact Person: Scott Sangalang <br /> Project Name: NO <br /> C7 �° <br /> Purchase Order Number: n tv �� u <br /> Quote Number: 'v` J lJr <br /> Sam ler(s) E w Z y 0 <br /> p o O <br /> 4. <br /> o O <br /> Sampling Fee: Pickup Fee: .S °� p0„ <br /> c. <br /> Compositor Setup Date: I I Time: 1 E —°' Z O A <br /> c _ <br /> Cd <br /> Lab Number: STKpl w�' / 3-17919 0 a <br /> u O <br /> c 0 Ey 04 u0i> <br /> Samp Date Time .S a, 0 Q E <br /> Num Location Description Sampled Sampled H a° pq Aa O wCD <br /> 19t I <br /> G DW 3 <br /> Remarks: Relinquished Date: Time: Re' 'shed Date: Time: Relinquished Date: Time: <br /> t*'y -3 <br /> 3 <br /> I By: Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> .31-7 <br /> Cor�rate Offices&Laboratory&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)392-2053 Fax:(209)942-0423 Fax:(530)343-3807 Fax:(805)783-2912 Fax:(559)734-8435 <br />
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