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i _ V IRONMENTAL.= AGRICULTURAL <br />'6 Analytical Chemists <br />Special CHAIN OF CUSTODY <br />P www.fgUnc.com <br />Laboratory Q;opy (1 of 3) <br />F <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Office & Laboratory <br />2500 Stagecoach Road <br />35730:02/06/2017 <br />TEST DESCRIPTION See Reverse side for Container, Preservative`and Sampling information <br />Client: San.Joaquin County EHD <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />3 <br />a <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />u <br />Stockton, CA 95205 <br />3 <br />= <br />c. <br />Phone: (209)468-0331 Fax: <br />C'7 <br />W <br />Contact Person: Rodney Estrada <br />Project Name: <br />Purchase Order Number: <br />3 <br />a <br />—' <br />Quote Number: ST 20160309-01 <br />0 <br />o <br />z <br />E <br />P <br />p <br />o <br />o <br />H <br />Sampler(s) <br />v�h(n5� (s <br />0 <br />vWi <br />T <br />Ln <br />a <br />Sampling Fee: Pickup Fee: <br />g? <br />o <br />o <br />o <br />¢ o <br />c4 N <br />w <br />A <br />Compositor Setup Date: _/ / Time: / <br />E <br />v� <br />o <br />a <br />E <br />w <br />c <br />z <br />a. <br />O <br />a <br />v <br />o vai <br />�' N° <br />o Z <br />a <br />° <br />E zF- <br />a <br />2 z <br />a <br />E <br />a <br />Lab Number: STKJ3. / 3-17919 <br />0 <br />0 <br />° <br />F� <br />04 <br />o — <br />Samp <br />LocationDescription <br />Date <br />Time <br />.5!to-- <br />0 <br />'soo <br />71 <br />— <br />6Num <br />Sampled <br />Sampled <br />w <br />w 0 <br />CU <br />N <br />: <br />i1=. <br />1 <br />V\1,` F �� <br />�ii..S'. <br />:Cj <br />G <br />DW <br />Remarks: <br />Relinquished Date: Time: <br />R "'shed Dte: Time: <br />�/� /5/�' Rb <br />tnq s Date: ime: <br />I305 <br />i <br />Re c 'ved By: Date: Time: <br />Received By: ate: Time: <br />tme: <br />Receiv d B D tRILL <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Office & Laboratory <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />i <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />