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WP0043695
Environmental Health - Public
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120 (STATE ROUTE 120)
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12870
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043695
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Entry Properties
Last modified
11/19/2024 4:01:51 PM
Creation date
6/20/2023 8:41:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043695
PE
4370
STREET_NUMBER
12870
Direction
E
STREET_NAME
STATE ROUTE 120
City
MANTECA
Zip
95336-
APN
22804005
ENTERED_DATE
8/31/2022 12:00:00 AM
SITE_LOCATION
12870 E HWY 120
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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-4 N <br /> CUS <br /> ENVIRONMENTAL . , <br /> Special Cxwww�.fg�.eo1mODY <br /> Analytical Chemists Customer Copy (2 of 2) <br /> II I IIIIII'II <br /> 11111111111111111111111111111111111 IN 35730:04/03/2023 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 /> Attn: Scott Sanglaang x <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 <br /> a <br /> Phone: (209)468-3452 Fax: <br /> Contact Person: Scott Sangalang Q <br /> Project Name: <br /> a 3 <br /> Purchase Order Number: U <br /> w ¢ a w <br /> Quote Number: ST 20160309-01LLI <br /> x <br /> E F- <br /> Sampler(s) 0 w z T O Q <br /> U * = Ln a a O <br /> bL i5 'C fa/] ¢- t7a <br /> Sampling Fee: Pickup Fee: E ? a_ a CIA x F- <br /> a, C i N t+1 n'"� N <br /> Compositor Setup Date:_/_/ Time: / E Q z p v " d °O `—'z 6 <br /> -- n E °voi oz cZ w Q E- <br /> 0 <br /> Lab Number: STK 3-17919 0 w ii a v E a a v n <br /> 0 0 H ao <br /> Samp Date Time <br /> " o <br /> Num Location Description Sampled Sampled o <br /> cv <br /> 1 G DW 1 1,1 <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: Date: Time: 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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