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State of California—California Environmental Protection Agency <br /> Department of Toxic Substances Control <br /> Northern California Region OFFICIAL SAMPLE RECEIPT Southern California Region <br /> Sacramento Office <br /> 1001 I Street Chatsworth Office <br /> Sacramento, CA 95812-0806 9211 Oakdale Avenue <br /> �— Chatsworth, CA 91311-6505 <br /> Cal Center Office <br /> 8800 Cal Center Drive Cypress Office <br /> Sacramento, CA 95826-3200 5796 Corporate Avenue <br /> Cypress, CA 90630-4732 <br /> 700 Heinz Avenue San Diego Office <br /> Berkeley, CA 94710-2721 9174 Sky Park Court, Suite 150 <br /> San Diego, CA 92123-4340 <br /> Clovis Office <br /> 1515 Tollhouse Road Imperial County CUPA Office <br /> Clovis, CA 93611-0522 627 Wake Ave <br /> EI Centro, CA 92243 <br /> Firm Name <br /> Stockton Propeller, Inc. Date <br /> Address 06/03/2021 Zip Code <br /> 2478 Wilcox Road City Stockton, CA 95215 <br /> Cl".k �00 0�e Gly S V�/�C nw et a. U�)vea'o ��s vw <br /> The items listed below were collected as official samples on this date as authorized by Section 66272.1, California Code of <br /> Regulations,Title 22. <br /> Quantity Unit Size Sample Description ID Number <br /> I U&L" - ba-4c bmupri ►� �c�� P-DqA <br /> L.I�.,�,� d �� � bt"g% I cod®f <br /> �2® L► vl r) &", .1A ®r <br /> U ram,`0 b r e\ eoo f <br /> Z' La j VA-G- f 6+, 6 S p, <br /> 7 2J U5 sio,ocr <br /> Receipt acknowledged b <br /> �c� cpo c — By: <br /> P int and Sign Authorized Agent <br /> DISC 1237(04/12) 1 <br /> 1 <br />