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KMCI mri OF CUSTODY <br /> Special www.fglinc.com <br /> Analytical Chemists Field Copy (3 of 3) <br /> 35730:02/06/2017 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 <br /> Attn: Rodney Estrada <br /> 1868 East Hazelton Ave. v <br /> Stockton,CA 95205 3 <br /> n. <br /> Phone: (209)468-0331 Fax: <br /> Contact Person: Rodney Estrada , Ln d L p <br /> Project Name: W„ <br /> Purchase Order Number: U w 3 <br /> W <br /> Q a p <br /> Quote Number: ST 20160309-01 x N <br /> 00 <br /> Sampler(s) E w z2 Ca <br /> T O .a <br /> * x <br /> Sampling Fee: Pickup Fee: <br /> Compositor Setup Date: / / Time: / E a Z O '__'Z °O y z E <br /> M c a ❑ Z, <br /> 0 <br /> Lab Number: STK 3-17919 0 o a E~ a a a E~ n a <br /> Samp Date Time o o <br /> c ° x <br /> Num Location Description "' <br /> Sam led Sam led " ' ° O ° N " y <br /> P P ' - a m W O U- C7 <br /> 1 G DW <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 />