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Special <br />CHAIN OF CUSTODY <br />www.fglinc.com <br />Field Copy (3 of 3) <br />Corporate Offices &Laboratory Office & Laboratory Office & Laboratory Office & Laboratory Office 8 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 />35731:02/06/2017 <br />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 <br />.1 <br />Attn: Rodney Estrada <br />� <br />� <br />1868 East Hazelton Ave. <br />� <br />� <br />Stockton, CA 95205 <br />� <br />Q. <br />Phone: (209 468-0331 Fax: <br />> <br />� <br />w <br />3 <br />� <br />Contact Person: Rodney Es[rada <br />� <br />Q <br />d <br />� <br />H <br />a, <br />� <br />Project Name: <br />� <br />� <br />� <br />� <br />� <br />Purchase Order Number: <br />U <br />ua <br />� <br />�' <br />;; <br />w <br />¢ <br />� <br />rx <br />Quote Number: ST 20160309-01 <br />'o <br />� <br />� <br />w <br />a <br />� <br />� <br />Samplers) <br />o <br />� <br />z <br />>, <br />O <br />U <br />* <br />� <br />v7 <br />� <br />^ <br />� <br />o <br />O <br />c a <br />� <br />Sampling Fee: Pickup Fee: <br />g <br />'�' <br />; <br />o � <br />R, <br />c <br />� <br />Compositor Setup Date: / /_ Time: /_ <br />� <br />� <br />—°'�, <br />8 <br />Z <br />O <br />.. <br />a <br />a � <br />� <br />Ca <br />Lab Number: STK 3-17919 <br />0 <br />� <br />a <br />� <br />� ,-. <br />� p <br />0 <br />0 <br />°: <br />H <br />rx � <br />� <br />Samp <br />Date <br />Time <br />� <br />a <br />o <br />� <br />� '� <br />a o <br />Num <br />Location Description <br />Sampled <br />Sampled <br />� <br />w <br />as O <br />w v <br />F.. <br />a. <br />0 <br />Travel Blank <br />G <br />LBW <br />4 <br />1 <br />G <br />DW <br />4 <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Corporate Offices &Laboratory Office & Laboratory Office & Laboratory Office & Laboratory Office 8 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 />