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WP0045379
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0045379
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Entry Properties
Last modified
8/5/2024 2:43:45 PM
Creation date
6/7/2024 9:27:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0045379
PE
4378
STREET_NUMBER
12445
STREET_NAME
LIBERTY
STREET_TYPE
RD
City
GALT
Zip
95632-
APN
00720023
ENTERED_DATE
3/25/2024 12:00:00 AM
SITE_LOCATION
12445 LIBERTY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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- <br /> Special CHMN OF CUSTODY <br /> '-tNVIRONMENTAL AGRICULTURAL <br /> P www.fgUnc.com <br /> 3Analytical Chemists Customer Copy (2 of 2) <br /> II�IIr- I'I�III_III�iIII�1��IIIIIIII�IIIII�IIIIIIIIIIIIIIIIII�'I 35730:11/01/2023 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 3 a <br /> Attn: Scott Sanglaang x <br /> 1868 East Hazelton Ave. ?; <br /> Stockton,CA 95205 3 = <br /> Phone: (209)468-3452 Fax: <br /> Contact Person: Scott Sangalang Q d 7 <br /> Project Name: <br /> Purchase Order Number: w <br /> Quote Number: ST 20160309-01 <br /> F- <br /> Sampler(s) E Z T O O <br /> * = y a O <br /> �1n` a w 0 x H <br /> Sampling Pickup Fee: 5 ;, o b s� a <br /> Compositor Setup Date: /_/_ Time:_1_ E n. z O °-_'z v ,�-�,z E <br /> E o vei o g ii Q F <br /> Lab Number: STK 3-17919 0 a <br /> Ea is F II a c <br /> O o <br /> Samp Location Description Date Time o 0" 0 0 L a 2 <br /> Num Sampled Sampled F.' a w O U O N is. <br /> i — G DW <br /> t <br /> i <br /> IRelin,uished Date: Z'_rtitel"atlaislted Dace: time: [Relinquished Date.: Time: <br /> '?Wreu;c;; Date: :_. h':ecai:rd.=- - Date: Time: IReoeived By: Date: Time: <br /> I <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory_ <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Undo 3442 Empresa Drive,Suite D 9411 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:(53.0)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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