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WP0043292
Environmental Health - Public
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4300 - Water Well Program
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WP0043292
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Entry Properties
Last modified
9/14/2022 9:39:36 AM
Creation date
8/1/2022 10:53:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0043292
PE
4378
STREET_NUMBER
22516
Direction
S
STREET_NAME
ALICE
STREET_TYPE
RD
City
MANTECA
Zip
95337-
APN
22614027
ENTERED_DATE
5/12/2022 12:00:00 AM
SITE_LOCATION
22516 S ALICE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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FGL Special CHmrl OF CUSTODY <br /> • P www.fgunc.com <br /> Analytical Chemists Llboratory Copy (1 of 3) <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 35731:08/02/2021 TEST DESCRIPTION - See Reverse side for Container,Preservative and Sampling info adou <br /> Client: San Joaquin County EHD <br /> Address: San Joaquin Co.Environmental Health Dep <br /> Water Quality Division' ,.a <br /> Atm: Michael Kith °i <br /> a <br /> 1868 East Hazelton Ave. 3 � <br /> Stockton,CA 95205 m <br /> v <br /> Phone: (209)468-3444 Fax: , C <br /> Contact Person: Michael Kith <br /> Project Name:^fuci\' <br /> A <br /> Purchase Order Number: U 3 hv e <br /> 5 a O <br /> Quote Number: 'o z ¢ �' u <br /> E <br /> Sampler(s) E n <br /> QS�4A? �DO�Cc�� 1 U a FZ _ <br /> a <br /> Sampling Fee: Pickup Fee: pr o g <br /> Q � m <br /> Compositor Setup Dale:_/_/_ Time: n a Z p a W <br /> vi E �ti yam. <br /> Lab Number: STK 3-17919 `o 2 o. T ,� <br /> 0 o <br /> Samp Date Time <br /> Num Location Description ampled Sampled 2 1 <br /> I �Avx) .N � N J— 1.Ob G DW Sub-3 <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> ti5�� � titi 125 ZZ I�� <br /> Received By ate Time: R By, I bate: Time: Received By: Date: Time: <br /> � 25ZZi2 L � ZSZZ (7D1� <br /> Coroorate Offices&Laboratory Office&Laboratory Office&Laboratory Off1ce&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)5254172/Ag Fax:(805)392-2063 Fax:(209)942-0423 Fax:(530)343-3807 Fax:(805)783-2912 Fax:(559)7348435 <br />
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