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AP2401108
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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AP2401108
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Entry Properties
Last modified
1/9/2025 3:00:31 PM
Creation date
11/22/2024 11:36:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
AP2401108
PE
4370 - WELL REPLACEMENT-Existing Well Not Viable
STREET_NUMBER
11425
Direction
E
STREET_NAME
BENNDORF
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
Closed - Issued
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
11425 E BENNDORF RD ACAMPO 95220
Tags
EHD - Public
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CHAIN OF CUSTODY <br /> Special www.fgUnc.com <br /> Analytical Clicnii-sts Laboratmy Copy (1 of 2) <br /> 1911111 U111 III[milli 11111 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 a <br /> Attn:Scott Sanglaang p; <br /> 1868 East Hazelton Ave. 3 u <br /> Stockton,CA 95205 <br /> a. <br /> Phone: (209)468-3452 Fax: <br /> Contact Person: Scott Sangalang <br /> Project Name: I�� d/`� u' c7 Ca N <br /> Purchase Order Number: V w 3 n " <br /> Quote Number: ST 20160309-01 y .. <br /> Sampler(s) U 0 a a <br /> Q C ¢O <br /> Q- W <br /> Sampling Fee. Pickup Fee: c� F4 <br /> ccn <br /> 0 1a, a� <br /> Compositor Setup Date: I / Time: I z O w °:z z c E <br /> conE cw 0 at~ iz� A H <br /> Lab Number: STK ' 4 79A 3-17919 0 W v <br /> amp Date Time .3� , a y 2 c 'b x 'ti V <br /> Num Location Description Sampled Sampled " rin <br /> a cc aq O v 0 ' 'ss. <br /> u. <br /> G DW 1 <br /> Remarks: Relinquished Date: Time: R ' ' hed Date: Time: Relinquished Date: Time: <br /> !�orX55 1,5 ,J17Jt GLS � � ZY 133 <br /> ed By. D te: Time: Received By: pate: Time: Received By: Date: Time: <br /> �,a 1-;55 r6 AVL f /,/ 2y /3 36 <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 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:(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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