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CHAIN OF CUSTODY <br />Special www.fglinc.com <br />Customer Copy (2 of 3) <br />1111111111111111111111111111 35731:02/06/2017 TEST DESCRIPTION See Reverse side for Container, Preservative and Sampling information <br />Corporate Offices &Laboratory Office $ Laboratory Office & Laboratory Office & Laboratory <br />Client: San Joaquin County EHD <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. <br />Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Address: San Joaquin Co. Environmental Health Dep <br />Stockton, CA 95215 <br />Chico, <br />CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: <br />(530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />Phone: (209)468-0331 Fax: <br />Fax: (559) 734-8435 <br />w <br />3 <br />Contact Person: Rodney Estrada <br />Project Name: <br />Purchase Order Number: k�0Of#L�iH'ii (P� G f ^ 1�� <br />�a <br />Quote Number: ST 20160309-01 <br />U <br />Y <br />o <br />U <br />0 <br />0 <br />Ps <br />w <br />W <br />* <br />Eco <br />0 <br />F' <br />Q <br />z <br />a. <br />a <br />>� <br />> <br />v� <br />U <br />H <br />co <br />o4 <br />O <br />o� <br />tx0 <br />w O <br />Q <br />p <br />�> <br />w <br />Samplers),- <br />c (� <br />Sampling Fee: Pickup Fee: <br />Compositor Setup Date: Time: <br />Lab Number: STK 3-17919 <br />SampDate <br />Num <br />Location Description <br />Sampled <br />Time <br />Sampled <br />0 <br />Travel Blank <br />G <br />LBW <br />4 <br />1 <br />G <br />DW <br />4 <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. <br />Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, <br />CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: <br />(530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />