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<br />CHAIN OF CUSTODY <br />wwwiglinc.com <br />Customer Copy (2 of 3) <br /> <br /> <br />Special <br /> <br />EIVIRCINMENTAL AGRICULTURAL <br /> <br />Analytical Chemists <br /> <br />1111111111 E11111111111111111111111111111111111111111 35730:02/06/2017 TEST DESCRIPTION - See Reverse side for Container, Presetwative and Sam ling information <br />Client.; <br />Address: <br />Phone: <br />Contact <br />Project <br />Purchase <br />Quote <br />San Joaquin County EHD <br />San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Haze1ton Ave. <br /> <br />Stockton, CA 95205 <br /> <br />(209)468-0331 Fax: <br />Person:Rodnelstradt:. "i f,!.._, vei Ca Is( 0.)o r <br /> <br />Name: 2'.2--) I <br />Order Number: <br />Number: ST 20160309-01 Method of Sampling: Composite(C) Grab(G) 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) Coliform-Colilert-P/A 120m1(PBa)-Na2S203 General Mineral 250m1(P)-HNO3 , 16oz(P), 8oz(P) Field Test-Field pH !!pH = 15 MINUTE HOLD TIME!! Field - pH Date Field - pH Time 4, <br />Sampler(s) <br />Sampling <br />Compositor <br />1 , i 3 (701,--c,, t>,... Is- LA 16 <br />Fee: Pickup Fee: <br />Setup Date: / / Time: / <br />Lab Number: STK 3-17919 <br />Samp <br />Num Location Description Date <br />Sampled <br />Time <br />Sampled <br />1 G DW 1 1,1,1 <br />Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> <br />Received By: . ate: Time: <br /> <br />(. -4V 612 42,1 i --•-•< <br />Received By: Date: Time: Received By: Date: Time: <br />Corporate Offices & Laboratory Office & Laboratory Office & Laboratory Office & Labora orv Office & Laboratqry <br />853 Corporation Street 2500 Stagecoach Road 563 E. Lindo 3442 Empresa D ive, 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