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CHAIN OF CUSTODY <br /> • • . Special www.fglinc.com <br /> A" Field Copy (3 4,3) <br /> h <br /> 35' °0:02/0612017 TE'_ DESCRIPTION See Reverse -de for ' <br /> Co, imer,Preservative and Samplin nformation <br /> hent: San Joaquin Co ty EHD <br /> Address: San Joaquin Co. vironmental Health Dep <br /> Water Quality Division j <br /> Attn:Rodney Estrada <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 o <br /> Phone: (209)468-0331 Fax: ce <br /> a A X00 <br /> Contact Person: Rodney Estrada <br /> Project Name: <br /> Purchase Order Number: U w rn a W <br /> Quote Number: ST 20160309-01 a r3 x N <br /> EM 44 <br /> o H <br /> Sampler(s) E ww, z T O °O A <br /> O <br /> t ' �a ¢M 0 x <br /> Sampling Fee: Pickup Fee: <br /> Compositor Setup Date:_/_/_ Time:_/_ E z O p Z O z E <br /> Lab Number: STK 3-17919 0 a U m x w� A E~ <br /> 0 0 E� wo � a H 11 a c <br /> E v v o <br /> Samp Date Time �� Q '� o a o x <br /> Num Location Description Sampled Sampled H ao pq 10 O U C5 N <br /> 1 G DW <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received13�: Date: Time: Received By: D:uc: Time: Received By: Date: Time: <br /> (corporate Offices&Laboratory Office 8 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 /> a a'Vnta 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 />