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CIHmri OF CUSTODY <br /> ENVIRONMENTALFGL <br /> Special www.fgUnc.com <br /> Analytical Chemists Field Copy (3 t. F 3) <br /> WIWLIIDIILLs llL1�1�;�' .5730:02/06/2017 f1.iT DES�'li 'TION - See Reverse side for :maincr. Preservative and Sampli! informati-_i <br /> Client. San Joaquin County EHD <br /> Address: San Joaquin Co. Environmental Health Dep f <br /> Water Quality Division <br /> Attn:Rodney Estrada <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205cu <br /> a <br /> Phone: (209)468-0331 Fax: <br /> � w 3 <br /> Contact Person: Rodney Estrada Q ¢ a <br /> rx <br /> Project Name: b <br /> Purchase Order Number: <br /> b4 t7a <br /> Quote Number: ST 20160309-01 a ¢ �" �_ <br /> a w a 2 F" 00 F' <br /> Sampler(s) U w z Ca <br /> Oa' a <br /> iF O O C a. Q M 0 W <br /> Sampling Fee: Pickup Fee: E °: v o-t <br /> cG' <br /> Compositor Setup Date: / / Time: ! E Z <br /> o� U gx w Q F <br /> Lab Number: STK 3-17919 o w a a v ^ E a a c a <br /> b o v a F- II <br /> Samp Location Description Date Time o o v o n 7 <br /> Num Sampled Sampled �' �' Q p m O U- C7" u,_ : u.. u <br /> 1 G DW 1 I.I.I <br /> Remark~: Relinquished Date: Time: Relinquished Date: Time: Relinquished Datc: Time: <br /> Received By: Date: Time: Received By: Dare: Time: Received By: Date: Time: <br /> Coroorats 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 />