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WP0040933
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040933
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Last modified
11/22/2021 2:53:48 PM
Creation date
11/3/2021 1:23:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040933
PE
4370
STREET_NUMBER
1282
STREET_NAME
CORWIN
STREET_TYPE
DR
City
MANTECA
Zip
95337-
APN
22231005
ENTERED_DATE
6/30/2020 12:00:00 AM
SITE_LOCATION
1282 CORWIN DR
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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-- CHA11Y OF CUSTODY <br /> Al 7NMENTAL _AGRICULTURAL Special I www.fglinc.com <br /> Analytical Chemists Field Copy (3 of 3) <br /> 1111111111111111111111111111111111111 Nil 11111111111111111 35731:08/02/2021 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 <br /> Attn:Michael Kith <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 a <br /> Phone: (209)468-3444 Fax: w <br /> Contact Person: Michael Kith 2 <br /> Project Name: - '' I ` co <br /> - .._) '', ti. C7 w 9 0 <br /> PG 3 a T <br /> Purchase Order Number: a; <br /> Quote Number: <br /> Sampler(s) 0 vi Z > O A <br /> Sampling Fee: Pickup Fee: tK c <br /> a Q <br /> Compositor Setup Date: / / Time: / 2 z O cx w <br /> -- -- ji <br /> Lab Number: STK 3-17919 ow a .. <br /> c o aO <br /> ? H PGC7 <br /> Samp Date Time -S <br /> Num Location Description Sampled Sampled F aM O rn <br /> G DW Sub-3 <br /> Remarks Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: Date: Time: Received By: Date: Time: Received By: Date: 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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