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M -00 (A 0) 0) <br />X 0 <br />7 m <br />> <br />ceWg3 <br />cr) <br />OD <br />001 <br />OD Remarks: _ <br />0 <br />0z r ILab Number: Sampler(s) ktik ê. Sampling Fee: Pickup Fee: Compositor Setup Date: _I _I__. Time: / Client: Fruit Growers Laboratory, Inc. Address: FGL Environmental, Inc. 853 Corporation St. Santa Paula, CA 93060-3005 Phone: Fax: Contact Person: Project Name: //6-° _ (3-18039) Purchase Order Number: Quote Number: Qs <br />-3;...- <br />(3) <br />1 Location Description ,-.‹. . <br />...-;,. <br />4 <br />CI\ <br />Iv <br />"a.' Received By: / Date: Time: Y/N) ff7 rie <br />,,... I <br />0 Method of Sampling: Composite(C) Grab(G) 35866:08/07/2017 i <br />Type of Sample **SEE REVERSE SIDE** <br />0. Potable(P) Non-Potable(NP) Ag Water(AgW) <br />Bacti Type: Other(0) System(SYS) Source(SR) Waste(W) <br />13acti Reason: Routine(ROUT) Repe,at(RPT) Replace(RPL) <br />Other(0) Special(SPL) <br />........:"*.c) <br />— <br />Sub Contracted-Oryzalin <br />1000m1(AGJ) TEST DESCRIPTION - See Reverse side for Container. Preservative and Sampling information 0. <br />C . '.7.3. <br />P) <br />i Received By: Date: Time: Relinquished Date: Time: r Cl <br />2. <br />, i. <br />\CO <br />P <br />ff <br />, . -; <br />. -- s 9- Relinquished Date: Time: .