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WP0040688
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040688
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Entry Properties
Last modified
7/28/2021 2:23:53 PM
Creation date
7/28/2021 2:18:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040688
PE
4380
STREET_NUMBER
9450
Direction
N
STREET_NAME
LOWER SACRAMENTO
STREET_TYPE
RD
City
STOCKTON
Zip
95210-
APN
08408003
ENTERED_DATE
3/30/2020 12:00:00 AM
SITE_LOCATION
9450 N LOWER SACRAMENTO RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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FGL <br />'ENVIRONNIENTAL AGRICULTURAL <br />Arialyticd1 Clic:mists <br />Special <br />CHAIN OF CUSTODY <br />www.fglinc.com <br />Laboratory Copy (1 of 3) <br />JiI]J 1111111111111111111111113111 35731.02/06/2017 TEST DESCRIPTION - See Reverse side for Container. Preservative and Sampling information <br />Aient: San Joaquin County EHD <br />kddress: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />'hone: (209)468-0331 Fax: <br />:ontact Person: Rodney Estrada i <br />'roject Name: qq5.0 ,.(14 t-ower (-;,x; Al <br />'urchase Order Number:5 0 c--qofrii CA <br />Note Number: ST 20160309-01 Method of Sampling: Composite(C) Grab(G) Type of Sample **SEE REVERSE SIDE** Potable(P) Non-Potable(NP) Ag Water(AgW) _ Bacti Type: Other(0) System(SYS) Source(SR) Waste(W) Bacti Reason: Routine(ROUT) Repeat(RPT) Replace(RPL) Other(0) Special(SPL) I EPA 504.1-DBCP Only 40m1(VOA) >ampling <br />72ompositor <br />iampler(s),Dovc; 0‘. A40 054ecii <br />Fee: Pickup Fee: <br />Setup Date: /_I Time: / <br />...ab Number: STK / ,5 F4,,./ 4 3-17919 <br />Num <br />amp Date Location Description Sampled <br />Time <br />Sampled <br />0 Travel Blank OA 1 11 .- 50 G LBW <br />I WeA keek8, Cim 1 v50 G DW 4 <br />temarks: Relinquished . pate: Time: <br />_ <br />mhz\ 1316 <br />R . uished Time: 4/7 <br />?9,?-1 '7°- <br />Relinquished i <br />OA U 11 0 <br />Date: , Time: <br />(X) CI LA--) <br />Recei d By: ' Date: Time: <br />/i5 <br />Received By: Da Time: RFei d By: , Date: Time: <br />XS 6 b. <br />7 a9./ /7(TD bOn LAD <br />Coroorate 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
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