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WP0038346
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038346
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Entry Properties
Last modified
6/10/2019 12:31:35 PM
Creation date
9/27/2018 8:32:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038346
PE
4366
STREET_NUMBER
10877
Direction
S
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
STOCKTON
Zip
95215-
APN
20113003
ENTERED_DATE
5/29/2018 12:00:00 AM
SITE_LOCATION
10877 S JACK TONE RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
AGooderham
Tags
EHD - Public
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-_ CI MN OF CUSTODY <br /> =�a , , , Special www.fglinc.com <br /> ENVIRONMENTAL —Analytical Chernists Customer Copy (2 of 3) <br /> 111111111111 El11IiE1111111111111i11111111111E1111 35730:02;06.2017 TEST DESCRIPTION - See Reverse side for Container. PreservativI and Sampling information <br /> Client: San Joaquin County,EHD I <br /> Address: San Joaquin Co. Environmental Health Dep <br /> Water Quality Division <br /> Attn: Rodney Estrada <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 <br /> C- <br /> 41 <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada Q Q <br /> 5 � <br /> Project Name: <br /> Purchase Order Number: <br /> Quote Number: ST 20160309-01 Q N <br /> c ^ o E- <br /> Sampler(s) o y O <br /> Ci <br /> * x <br /> CLI <br /> ¢o ° w <br /> Sampling Fee: Pickup Fee: <br /> ' c _ <br /> Compositor Setup Date:_/ / Time: w F <br /> Ln <br /> 0 <br /> Lab Number: STK 3-17919 0 ay U a x v x <br /> b ` y EG <br /> Samp Location Description Date Time y =o d o x <br /> Num p Sampled Sampled p° ° p V t7�� %° [: z <br /> 1 G DW <br /> I <br /> I <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: Date: Time: Received By: Date: Time: Received By: Dane: 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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