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FGL Special CHMN OF CUSTODY <br /> EN�IRONMENTAL AGRICULTURAL <br /> p www.fgUnc.com <br /> { Analytical Chemists Customer Copy (2 of 3) <br /> 11111 F111111 11111-1111111111 IT IN F. <br /> 35731:02/06/2017 TEST DESCRIPTION See Reverse side for Container. Preservative and Sampling information <br /> tient. San Joaquin County EHD <br /> Address: San Joaquin Co.Environmental Health Dep <br /> Water Quality Division 3 a <br /> Attn:Rodney Estrada <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 <br /> Phone: (209)468-0331 Fax: w x <br /> Contact Person: Rodney Estrada <br /> Project Name: \\30\ <br /> Purchase Order Number: i <br /> g w Q a: <br /> Quote Number: ST 20160309-01 y p4 F <br /> a <br /> Sampler(s) o V) z > O <br /> 0 5a <br /> Sampling Fee: Pickup Fee: S ; o a <br /> t' °: o S �' ,�, U <br /> Compositor Setup Date:_/_/_ Time:_/_ 8 a z O c a A <br /> 0 <br /> Lab Number: STK 3-17919 0 rn ao. '. <br /> �O <br /> 0 0 ?? H a� �� <br /> Samp Date Time !SCU <br /> Num Location Description Sampled Sampled Ems' A. ra O M4 <br /> 0 Travel Blank �jl l�Gr V' G LBW 4 <br /> G DW 4 <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> Received By: Date: Time: 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 />