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CHAiri OF CUSTODY <br /> Special www.fgUnc.com <br /> Field Copy (:3 of 3) <br /> i 35731:02/06/2017 TEST DESCRIPTION - See Reverse side for Container,Preservative and Sa*ling information <br /> i' <br /> Client: San Joaquin County EHD. tf <br /> Address: San Joaquir.Co. Environmental Health Dep <br /> Water Quality Division a <br /> Attn:Rodney Estrada x <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 <br /> Phone: (209)468-0331 Fax: x <br /> Contact Person: Rodney Estrada A ¢ a <br /> Project Name: r% <br /> Purchase Order Number: <br /> Quote Number: ST 20160309-01 <br /> N <br /> G <br /> Sampler(s) Z T O <br /> U <br /> Sampling Fee: Pickup Fee: <br /> 'a c <br />_1 Compositor Setup Date:_/_/_ Time:_/_ EE z p a o <br /> i Lab Number: STK 3-17919 0 ii <br /> 0 0 <br /> Samp Date Time p p 'u d <br /> Num Location Description Sampled Sampled H a m m O 1 w a <br /> 0 Travel Blank G LBW 4 <br /> 1 G DW 4 <br /> Rcmarks: 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 />