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WP0040785
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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26606
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040785
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Entry Properties
Last modified
11/19/2024 3:48:25 PM
Creation date
11/12/2021 10:07:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040785
PE
4366
STREET_NUMBER
26606
Direction
E
STREET_NAME
STATE ROUTE 12
City
CLEMENTS
Zip
95227-
APN
02322005
ENTERED_DATE
5/4/2020 12:00:00 AM
SITE_LOCATION
26606 E HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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S ecial CHMN Of CUSTODY <br /> P www.,gUnc.com <br /> Laboratory Copy (1 of 3) <br /> -- Almhtictfl <br /> 1111 1H 1111111111111 iff 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 w <br /> Atm:Michael Kith <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 <br /> a <br /> Phone: (209)468-3444 Fax: x <br /> C7 w <br /> Contact Person: Michael Kith <br /> Project Name: ���Q �j�W° �� C7 w o <br /> a 3 �' a <br /> Purchase Order Number: v <br /> = W Q a O <br /> Quote Number: <br /> w a Q <br /> SamplerEs) ��,,_ `lo v� a O <br /> U .2a <br /> PIC <br /> Sampling Fee: Pickup Fee: a t'' o <br /> -a c <br /> Compositor Setup Date:_!—/_ Time: / E z O a fl w <br /> Lab Number: $Tj{ '/0 I 3-17919 0 a T m> <br /> o u F_ a� O`V <br /> amp jDate Time p r E <br /> Num <br /> Location Description led Samplleeda,'L� IQ G DW Sub-3 <br /> -RemarklRelinquish" e: Tim . u • <br /> cc By: Date- Time: Received By: Date: Time: Received By: Date: Time: <br /> ?QX9 r i <br /> &X494 6Q9, t7(0 <br /> 7L <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 /> r--.,c...,•lona%coc A470 I A-c—tanai ono onaa r- -19n0\OA9-nA94 C—lrQM'AAQ-,Ann7 Fav-lAnr.\7AQ_9019 Fav Irr,O\7QA-AAQa <br />
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