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- <br />Analytical Chemists <br />Special r +1, <br />ENVIRONMENTAL - AGRICULTURAL <br />CHAIN OF CUSTODY <br />www.fglinc.com <br />Laboratory Copy (1 of 3) <br />IIIIIIIIIIIIIIIIIIIIIIIIIIME1111111111111 35731.02/06/2017 TEST DESCRIPTION - See Reverse side for Container. Preservative and Sampling information <br />Client: San Joaquil Count) EHD <br />Address: San Joaquiq Co. Environmental Health Dep <br />Water Quality Division : <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />Phone: (209)468-0331 Fax: <br />Contact Person: Rodney Estrada <br />l Project Name: 5 i-IS-S— ; 03 ‘ Oln 0 0 -- Purchase Order Number: <br /> Quote Number: ST 20160309-01 Method of Sampling: Composite(C) Grab(G) Type of Sample **SEE REVERSE sirir-** Potable(P) Non-Potable(NP) Ag Water(AgW) Bacti Type: Other(0) System(SYS) Source(SR) Waste(W) Bacti Reason: Routine(ROUT) Repeat(RPT) Replace(RPL) Other(0) Special(SPL) EPA 504.1-DBCP Only 40m1(VOA) Sampling <br />Compositor <br />Sampler(s)T04,_) 0...., <br />ik-S/4614' <br />Fee: Pickup Fee: <br />Setup Date: / / Time: / <br />Lab Number: STK oeig pig 7 3-17919 <br />Samp <br />Num Location Description Date <br />Sampled <br />Time <br />Sampled <br />0 Travel Blank 51/617, pt.5S- G LB'vV A- <br />1 We, U 1-4AA _quo to:, sc G MA/ 4 <br />Remarks: Relinquished Date: Time: , <br />5/26/14 I tia <br />Relinquished Date: Time: <br />i-,,- A /g3'. glItit( t 11'1° <br /> elinq shed Date: Time: <br />- <br />Received By: Date: Time: Received <br />a, 6124 44 tr.(s" <br />y: Date: Time: <br />/ 2-67aa, It Ad <br />Rece'ved By: Date: Time: /..4,,, j7 z... <br />.... <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />Phone: (805) 392-2000 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Office & Laboratory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />Phone: (209) 942-0182 <br />Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Undo <br />Chico, CA 95926 <br />Phone: (530) 343-581 <br />Fax: (530) 343-3807 <br />e: (559) 734-9473 <br />) 734-8435