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WP0045032
EnvironmentalHealth
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120 (STATE ROUTE 120)
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22392
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4200/4300 - Liquid Waste/Water Well Permits
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WP0045032
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Entry Properties
Last modified
11/19/2024 4:01:51 PM
Creation date
11/20/2023 10:34:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0045032
PE
4373
STREET_NUMBER
22392
Direction
E
STREET_NAME
STATE ROUTE 120
City
ESCALON
Zip
95320-
APN
24509017
ENTERED_DATE
11/6/2023 12:00:00 AM
SITE_LOCATION
22392 E HWY 120
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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CHAIN OF CUSTODY <br />�. Special www.fgUnc.com <br /> ryryAnak,lical ChemistsLaboratory Copy (1 of 2) <br /> 1�NNIl� ( IflIIIIINil[111111 35731:01/01/2024 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 a <br /> Ann:Scott Sanglaang u <br /> 1868 East Hazelton Ave. <br /> H v <br /> Stockton,CA 95205 3 cc <br /> a <br /> a <br /> Phone: (209)468-3452 Fax: w <br /> Contact Person: Scott Sangalang opA <br /> /� <br /> V <br /> Project Name: ZZ 3C(Z (',A`Z O a cc W <br /> Purchase Order Number: �g�1CM 1 GA G > > a <br /> Quote Number: C-1 1.)7 p a <br /> Sample -ICA <br /> C z O <br /> e-_ I — 0 <br /> W U En <br /> .5 <br /> eo 0 <br /> Sampling Fee: Pickup Fee: <br /> p v O%a U <br /> Compositor Setup Date: I_I_ Time._! E ^n z O oco <br /> cce A <br /> Lab Number: STI{ ���� 3-17919 o ti a, 8. p <br /> o a °' F• a0 $> <br /> Samp Location Description Date Time T c ¢�o <br /> Num Sampled Sampled t. a w m 0 w a <br /> I w G 1 1.+1 M-L G DW 4 <br /> I <br /> Remarks: Reli uished Date: 'rime: Relinquished Date: Time: Relinquished Date: Time: <br /> '121 C-�—S Z ti`/ 12,417 <br /> Received By- Date:Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> NJI- <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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