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WP0042034
Environmental Health - Public
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4300 - Water Well Program
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WP0042034
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Entry Properties
Last modified
2/24/2022 1:42:21 PM
Creation date
2/24/2022 1:41:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042034
PE
4370
STREET_NUMBER
30163
Direction
E
STREET_NAME
HALL
STREET_TYPE
AVE
City
ESCALON
Zip
95320-
APN
24908010
ENTERED_DATE
5/12/2021 12:00:00 AM
SITE_LOCATION
30163 E HALL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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CHMN OF CUSTODY <br />Special www.fgUnc.com <br />Laboratory Copy (1 of 3) <br />35731:08/02/2021 <br />rLENVIRONMENTAL` <br />AGRICULTURAL <br />Analytical Chemists <br />Client: , San Joaquin County EHD <br />CHMN OF CUSTODY <br />Special www.fgUnc.com <br />Laboratory Copy (1 of 3) <br />Corporate Offices & Laboratory <br />35731:08/02/2021 <br />TEST DESCRIPTION =See Reverse side for Container, Preservative and Sampling <br />information <br />Client: , San Joaquin County EHD <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Address: San Joaquin Co. Environmental Health Dep <br />Env Fax: (805) 525-4172 1 Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Water Quality Division <br />l <br />3 <br />Attn: Michael Kith <br />a <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 =° <br />c <br />Phone: (209)468-3444 Fax: <br />C7 <br />w <br />3� <br />Contact Person: Michael Kith <br />A <br />Project Name: 30 \.k4—s \Ml� <br />� x <br />Purchase Order Number: <br />> <br />O <br />Quote Number: <br />y <br />E <br />a <br />w <br />z <br />E <br />T <br />Q <br />Sampler(s) <br />� <br />D <br />a <br />Sampling Fee: Pickup Fee: <br />E <br />° <br />C.a <br />tY <br />`v <br />_ <br />Compositor Setup Date: _/ / Time: <br />E <br />h <br />E <br />z <br />0 <br />O a <br />w <br />^ <br />Lab Number: STK 3-17919 <br />0 <br />ram <br />a <br />° <br />c e <br />06 <br />'� <br />E j <br />eo <br />O <br />amp <br />Location Description <br />Date <br />Time <br />Num <br />Sampled <br />Sampled <br />E~ <br />co M p <br />G <br />DW <br />Sub -3 <br />I <br />I <br />Remarks: <br />Relinquished Dace: Time: <br />Relin tsh Date: Time: <br />Relinquished Date: Time: <br />111.44-1 ��60 <br />ceived By/: Date: Time: <br />Receij Date: Time: <br />Received By: Date: I ime: <br />fB �J <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 1 Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />
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