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WP0043542
EnvironmentalHealth
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MICKE GROVE
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11250
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043542
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Entry Properties
Last modified
6/26/2024 11:12:27 AM
Creation date
6/5/2024 2:20:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043542
PE
4366
STREET_NUMBER
11250
Direction
N
STREET_NAME
MICKE GROVE
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
05914069
ENTERED_DATE
7/27/2022 12:00:00 AM
SITE_LOCATION
11250 N MICKE GROVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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Special CHAIN OF CUSTODY <br /> AGRICULTURAL www.fgUnc.com <br /> Customer Copy (2 of 2) <br /> Analytical Chemists <br /> III IIIIIIIIIIIIII III III IIIII'IIIIIIIIIIIIII'IIIIIIiI 35731:04/03/2023 TEST DESCRIPTION - Sev-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 /> Atm:Scott Sangiaang 3 <br /> 1868 East Hazelton Ave. ` <br /> a� <br /> Stockton,CA 95205 3 <br /> Phone: (209)468-3452 Fax: <br /> Contact Person: Scott Sangalang Q Q P aF <br /> W a? o <br /> Project Name: ��"��<v/U ��i� G��n� C4 3 v� <br /> Purchase Order Number: 777i�1 ? to 6 <br /> Quote Number: Z r4 <br /> L rt- C4 _ <br /> a W P. E� F" <br /> Sampler(s) E aZ O <br /> N/(,J <br /> Sampling Fee: — Pickup Fee: 5 ° ;, o: p <br /> n o c4 U <br /> Compositor Setup Date: /_/ Time:_/_ E K z <br /> Lab Number: STK 3-17919 o w a T p <br /> O O N H C4 CD <br /> Sam p Date Time S a '� Q E <br /> Nutn Location Description Sampled Sampled F' o°. m� m O w <br /> 1 G DW 3 <br /> Remarks Relinquished Date: Time: Relinquished Date: Time: (Relinquished Date: Time: <br /> ! Received By: Date: ;ime: Received By: Date. Time: Received By: Date: Time: <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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