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WP0038547
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038547
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Entry Properties
Last modified
6/12/2019 4:23:54 PM
Creation date
11/8/2018 8:28:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038547
PE
4378
STREET_NUMBER
16909
Direction
S
STREET_NAME
VAN ALLEN
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
205090210
ENTERED_DATE
7/13/2018 12:00:00 AM
SITE_LOCATION
16909 S VAN ALLEN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
AGooderham
Tags
EHD - Public
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- -= CHAIN OF CUSTODY <br /> Special www.fglinc.com <br /> ENVIRONMENTAL AGFUCULTURAL <br /> Analytical Chemists Customer Copy (2 of 3) <br /> 11 11h 11111111111 111ii 1111111111 IN IN 35730:02/06/2017 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:Rodney Estrada FS <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 <br /> d <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada A d <br /> Project Name: <br /> Purchase Order Number: j 30o y� a ui <br /> Quote Number: ST 20160309-01 <br /> ampler(s) a w a E" a°o F <br /> 6 o O �vai ¢O w <br /> Sampling Fee: Pickup Fee: 5 <br /> a oa^i a z g '� <br /> Compositor Setup Date:_/_!_ Time:_/_ z p o z c x w0 -Z co <br /> A H <br /> Lab Number: STK 3-17919 w 0 O a a a a <br /> 7E� H II <br /> Samp Date Timelu a as CC 6 o c <br /> ption o- 'Location Descri ` ° o <br /> uNum Sampled Sampled O [ -:H <br /> 1 G DW 1 1.1,1 ,J` • .� <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Datc: Time: <br /> Received By: Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> I <br /> Corborate 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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