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CHAIN OF CUSTODY <br /> P MSpecial www.fgUnc.comIM0461M <br /> Customer Copy (2 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 a <br /> Attn:Rodney Estrada <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 <br /> Phone: (209)468-0331 Fax: w x <br /> Contact Person: Rodney Estrada A Q <br /> L <br /> Project Name: S Z Lo I +t O N cn <br /> Purchase Order Number: ALR;`r' CA <br /> Quote Number: ST 20160309-0100 <br /> N ¢ o <br /> Sampler(s) (� o w z T O A <br /> oi- � U * A 4a x <br /> Sampling Fee: Pickup Fee: °i +''C4 p <br /> a <br /> Compositor Setup Date:_/_/_ Time:_/_ —Q z 0 a z 0 <br /> CIO) E 0 0 <br /> Lab Number: STK 3-17919 o 5 U a a c a <br /> F II <br /> Samp Date Time ' O CD <br /> °'C> <br /> Num Location Description oSampled Sampled 7P <br /> b <br /> 1 Gc G DW 1 1,1,1 Zj, ij <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: Date: Timc: 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 />