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WP0043373
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043373
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Entry Properties
Last modified
4/17/2023 11:29:11 AM
Creation date
4/3/2023 3:00:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043373
PE
4370
STREET_NUMBER
14555
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
20609035
ENTERED_DATE
6/8/2022 12:00:00 AM
SITE_LOCATION
14555 AUSTIN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Special CHAIN OF CUSTODY <br /> AGRICULTURAL P www.fgunc.com <br /> Analytical Chemists Customer Copy (2 of 3) <br /> IIIIIIIII VIII IIIIIII IIIIIIIIIIIIII IIIIIIIIII III 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 3 a <br /> Atm: Michael Kith x <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 =° <br /> Phone: (209)468-3444 Fax: x <br /> Contact Person: Michael Kith O Q i a <br /> �1 2 x <br /> Project Name: <br /> Purchase Order Number: <br /> Quote Number: <br /> o w a E E" �m <br /> Sampler(s) U O Q <br /> Sampling Fee: Pickup Fee: 'c <br /> _ 0 <br /> 7EL c Q <br /> Compositor Setup Date:_/ / Time: / EE o z O a w <br /> Lab Number: STK 3-17919 0 Un ii n j <br /> 0 0 H cG p C7 <br /> Samp Date Time -S <br /> Num Location Description Sampled Sampled H a° W O a <br /> I G DW Sub-3 <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: D�felTime: Received By: Date: 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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