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<br />CHAIN OF CUSTODY <br />www.fglinc.com <br />Laboratory Copy (1 of 3) <br /> <br /> <br />ECIL <br />ENV1RONM[NTAL 1 AGRICULTURAL <br /> <br />Special <br /> <br />Analytical Chemists <br /> <br />Client: <br />Address: <br />Phone: <br />Contact <br />Project <br />Purchase <br />Quote <br /> <br />1101111111111111111111111111111111111111111111111111 <br />San Joaquin County ii.:11D <br />San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />(209)468-0331 Fax: <br /> <br />Person: Rodney Estrada .c Ok)ke" VS <br />Name: fk...NNN <br />Order Number: <br />Number: ST 20160309-01 <br />35731.02/06/2017 TEST Dk.SCRIPTION - See Reverse side for Container, Preservative and Sampling infotmation I Method of Sampling: Composite(C) Grab(G) I Type of Sample **SEE REVERSE SIDE** 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) .t <br />Sampler(s) <br />y%`-ltc)t. <br />Sampling <br />Compositor <br />Q.111% S° ‘C(1>•• <br />Fee: — Pickup Fee: <br />Setup Date: / / Time: / <br />Lab Number: STK c,/3 , & 3-17919 <br />Samp <br />Num Location Description Date <br />Sampled <br />Time <br />Sampled <br />0 Travel Blank <1\\\, G LBW -47- <br />1 \\....401 /4.),,..2.,\)\44. %At\ \ex; , AG DW 4 <br />Remark: Relinquished Date: Time: <br />‘ \l 1—\ \AU <br />Relini. itislied 6.4 yolD7 : Time: <br />3491 .1-1 1-\ <br />: -linqu'.. i Date: e: <br />( <br />Date: Time: <br />`54/3C).! <br />Received By: Date: Time: A.4. : : Date: Time: <br />Corporate Offices & Laboratory Office & Laboratory Office & Laboratory Office & Laborato Office & Laboratory <br />853 Corporation Street 2500 Stagecoach Road 563 E. Lindo 3442 Empresa Drive, Suite D 9415W. 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