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WP0043813
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043813
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Entry Properties
Last modified
4/17/2023 11:26:10 AM
Creation date
12/9/2022 3:12:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043813
PE
4370
STREET_NUMBER
6154
Direction
S
STREET_NAME
MOBLEY
STREET_TYPE
RD
City
STOCKTON
Zip
95215-
APN
18513004
ENTERED_DATE
9/21/2022 12:00:00 AM
SITE_LOCATION
6154 S MOBLEY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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ME CHAIN OF CUSTODY <br /> ENVIRONMENtAL— —I— AGRICULTURAL <br /> Special www.fglinc.com <br /> Analytical Chemists Laboratory Copy (1 of 3) <br /> I III III II I II VIII III VIII III IIII 35731:08/02/2021 TEST DFSCR=ON - 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 c ,j <br /> Atm: Michael Kith 6 °' <br /> 1868 East Hazelton Ave. 3 . <br /> Stockton,CA 95205 iO <br /> n <br /> a <br /> Phone: (209)468-3444 Fax: <br /> Contact Person: Michael Kith � c.� h Y <br /> Project Name:��S�l 'j� to m ti <br /> Purchase Order Number: <br /> °p N a o <br /> Quote Number: o to G u' U <br /> a m <br /> Sampler(s) U y � h a0 q <br /> ;q w O ti <br /> Sampling Fee: Pickup Fee: .5 <br /> G e or o m Q <br /> Compositor Setup Date:_/_/_ Time: / E a z O$ aun <br /> Lab Number: STK d..)�' ��� 3-17919 `o y a, j <br /> o v F' aO p`� <br /> Samp Date Time 3 0• -� '� u a E <br /> Num <br /> Location Description Sampled Sampled F o m m O m�v <br /> 1 A.. G DW Sub-3 <br /> Remarks: linquis Date: Time: Reltnq 'shedDate: Time: Relinquished Date: Time: <br /> ed By: Date: Time: Received By: ate: Ti Received By: Date: Time: <br /> Corporate Offices&Laboratory '--QffigfAUboratory 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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