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WP0042765
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042765
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Entry Properties
Last modified
8/30/2023 4:33:09 PM
Creation date
6/10/2022 1:42:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042765
PE
4366
STREET_NUMBER
30051
Direction
E
STREET_NAME
GROOMS
STREET_TYPE
RD
City
OAKDALE
Zip
95361-
APN
20729060
ENTERED_DATE
11/29/2021 12:00:00 AM
SITE_LOCATION
30051 E GROOMS RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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Tags
EHD - Public
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QWN OF CUSTODY <br /> Special www.fgUnc.com <br /> Laboratory Copy (1 of 3) <br /> 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 a <br /> Attn:Michael Kith .. <br /> 1868 East Hazelton Ave. o'0 '. <br /> cc <br /> Stockton,CA 95205 3 .= <br /> a <br /> Phone: (209)468-3444 Fax: <br /> Contact Person: Michael Kith <br /> Project Name: <br /> Purchase Order Number: O <br /> Quote Number: <br /> 1~ <br /> Sampler(s) N Z a0 D <br /> Sampling Fee: Pickup Fee: 5 a L a <br /> a <br /> Compositor Setup Date: l I Time: I EE z o a w <br /> L rA E o� <br /> Lab Number: STK 3-17919 0 �% <br /> 3 a a <br /> V 0 H u:0 V <br /> Samp Date Time •5 � '� v <br /> Num Location Description Sampled Sampledi t~ a oa ca O vi v <br /> Ij'fG DW Sub-3 <br /> Remarks: Relinquished Date: Time: Rclinq fished ate: Time: Relinquished Date: Time: <br /> I 13��- = 3 �;-7 L 12(p(Z3 !i jS <br /> R By: Date: Time: Received By: ate: 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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