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1 FGL <br />PZIVIROfyMENTAL AGRICULTURAL <br />Analytical Chemists <br />Special CHMN OF CUSTODY <br />P rUUM <br />v, <br />Laboratory, Copy (1 of 3) <br />s <br />Corporate Offices & Laboratory_ <br />35730:02/06/2017 <br />TEST DESCRIPTION)- See Reverse side for Container, Preservative and Sampling <br />information <br />Client: San Joaquin County EHD <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (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 />Address: San Joaquin Co. Environmental Health Dep <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-0331 Fax: <br />C7 <br />Lc1 <br />n" <br />Contact Person: Rodney Estrada <br />Project Name: <br />Purchase Order Number: <br />> <br />Quote Number: ST 201603099-01 <br />U <br />rn <br />0.. <br />00 <br />Q <br />Sampler(s) <br />a <br />Sampling Fee: Pickup Fee: <br />c <br />G <br />a <br />a <br />Compositor Setup Date: / / Time: / <br />E <br />= <br />z <br />O <br />x <br />� <br />v Z <br />0 <br />0 <br />6 <br />w <br />o <br />a <br />u <br />T <br />F <br />$v' <br />a� <br />U <br />a_ <br />o. <br />9x <br />w <br />-• <br />HII <br />A <br />n <br />F <br />n <br />Lab Number: STK <br />3-17919 <br />Samp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />, <br />E- <br />C <br />a <br />M <br />oa <br />'V 6 <br />at O <br />014 <br />U -•0 <br />d W) <br />N <br />� 0, <br />V. =: <br />s <br />k. <br />1 <br />�� �� ' 1 <br />' 1. <br />;3v <br />G <br />DW <br />1 <br />Remarks: <br />Relinquished Daft: Time: <br />Relinquish d Date: Time: <br />uish Dape: 1'fe: <br />0� Z Q0 D <br />I <br />r7l <br />Received B Date: Time: <br />Received B Date: Time: <br />eiv ate: tme: <br />/fi� <br />3& <br />Corporate Offices & Laboratory_ <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (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 />