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CHAIN OF CUSTODY <br /> cb <br /> FEE Special www.fgmc.com <br /> ENVIRONMENTAL _�_ AGRICULTURALAnalytical Chemists i, o- Customer�Copy (2 of 3) <br /> t q j <br /> 35731:02/06/2017 TEST DESCRIPTION - See Reverse side for'Con tain ,Preservative and Sampling information <br /> Client: San Joaquin County EHD <br /> Address: San Joaquin Co.Environmental Health Dep i # <br /> Water Quality Division a k <br /> Attn:Rodney Estrada <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 a <br /> Phone: (209)468-0331 Fax: a: <br /> Contact Person: Rodney Estrada <br /> Project Name: ke 11 w ? o <br /> Purchase Order Number: �.1� A u > <br /> Quote Number: ST 20160309-01 <br /> c w Y F <br /> S pler(s) 0 � Z <br /> Z T 0O <br /> � P4a 2 � <br /> Sampling Fee: Pickup Fee: 9 0 � �� O � <br /> C y 4 U <br /> Compositor Setup Date: / / Time: /— Q z O <br /> Lab Number: STK 3-17919 0 w a 40 <br /> c <br /> Samp Date Time 7 <br /> Num Location Description Sampled Sampled H a PQ pq O w <br /> 0 Travel Blank a��l I1 4, !4 G LBW %;�_ �..Z <br /> 1 #y I (4 G DW 4 <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> •"( ; s" fm -�-Ii* I <br /> Received By- Date: Time: Received B%: Date: Time: Received By: Date: Time: <br /> �M 3 <br /> Corwrate 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 />