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WP0040807
Environmental Health - Public
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4300 - Water Well Program
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WP0040807
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Entry Properties
Last modified
5/10/2021 11:35:36 AM
Creation date
5/10/2021 11:32:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0040807
PE
4366
STREET_NUMBER
11099
Direction
E
STREET_NAME
SOUTHLAND
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
20805013
ENTERED_DATE
5/11/2020 12:00:00 AM
SITE_LOCATION
11099 E SOUTHLAND RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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Special CHAIN OF CUSTODY <br /> www.fganc.com <br /> V-9VTI'MMENTAL AGRICULTURAL <br /> Analytical Chernists Laboratory Copy (1 0 3) <br /> r <br /> 35730:02/06/2017 TOT DESCRIPTION - See Reverse side for Container,Preservative and Sampliq information <br /> Client: San Joaquin County EHD <br /> Address: San Joaquin Co..Environmental Health Dep <br /> Water Quality Division j <br /> Atm:Rodney Estrada <br /> 1868 East Hazelton Ave. 3 3 <br /> Stockton,CA 95205 a <br /> Phone: (209)468-0331 Fax: P4 <br /> c7 w 3 <br /> Contact Person: Rodney Estrada <br /> Project Name: \,\C, <7y K,r►^ <br /> Purchase Order Number. „ Cfl" <br /> > ¢ Y x <br /> Quote Number: ST 20160309-01 o w `✓ _ <br /> B o <br /> Sampler(s) E w z y O A <br /> o v) a O a0 <br /> U ar a. <br /> � <br /> Sampling Fee: Pickup Fee: .5 a o <br /> Compositor Setup Date: / / Time: / zO a =�z72 <br /> --- -- d E c c e zcn <br /> E- <br /> Lab Number: STK ' 3-17919 0 CIS <br /> ii K V a a ? c c <br /> Samp Date Time �s Q :670 :2o o <br /> '� = x b <br /> Num Location Description Sampled Sampled " ' C `d o N <br /> P P F- w M O 0-• 0 cu 4. <br /> G DW <br /> Remarks: Relinquished Date: Time: Relinquished ate: Time: i ed Da e: T' ie: <br /> Received By: Date: Time: Received By: ate: Ti e: cei B D te: ime: <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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