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WP0038449
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038449
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Last modified
11/19/2024 3:48:24 PM
Creation date
6/12/2019 3:25:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038449
PE
4366
STREET_NUMBER
11136
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
05114054
ENTERED_DATE
6/19/2018 12:00:00 AM
SITE_LOCATION
11136 HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
AGooderham
Tags
EHD - Public
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CHAIN OF CUSTODY <br /> ENVIRONMENTAL AGRICULTU <br /> RAL Special www.fglinc.com <br /> Analytical Chemists <br /> Field Copy (3 of 3) <br /> 35730:02116/2017 TEST DESCRIPTION - See Reverse side for Container,,I't rvative and Sampling info imat iom <br /> Client: San Joaquin County EHD <br /> I <br /> ]Address: San Joaquin Co. Environmental Health Dep <br /> Water Quality Division 3 <br /> Attn: Rodney Estrada <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 0 <br /> Phone: (209)468-0331 Fax: <br /> Contact Person- Ro Estrada 1. A ¢ 2 a <br /> Project Name. � uuN <br /> .V•� ) ) w °= <br /> J ✓ v� a Ln as <br /> Purchase Order Number: u w 60. <br /> w w <br /> ¢ w <br /> Quote Number: ST 20160309-01 o � <br /> Samplers) � <br /> h � z � a <br /> i <br /> y a <br /> 5 <br /> Sampling Fee: Pickup Fee: u o O . ¢O �° w <br /> x trN �, �Z <br /> Compositor Setup Date: / / Time: / �' z b p _v z E <br /> Lab Number: STK 3-17919 — E fl b U rA — <br /> _ <br /> Same Date Time =o c E <br /> Location Description y , b o <br /> Num Sampled Sampled t m m O V C7 w e <br /> I G DW I I.LI <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> .l�nr w �.,I KSS"t• �!".1 <br /> Received By: \ Date: Time: Received BN: Date: Time: Received By: Date: Time: <br /> r' <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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