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<br />CHAIN OF CUSTODY <br />www.fglinc.com <br />Field Copy (3 of 3) <br /> <br /> <br /> <br />- - . <br />ENVIRONMENTAL AGRICULTURAL <br /> <br />Special <br /> <br />Analytical Chemists <br /> <br />1111111111111111111111111111101111ilin II_ Illi III 35730:02/06/2017 <br />. <br />TEST DESCRIVFIGN - See Reverse side for Container. Preservative and Sampling information <br />Client: <br />Address: <br />Phone: <br />Contact <br />Project <br />Purchase <br />Quote <br />San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />(209)468-0331 Fax: <br /> <br />Person: Rodney Estrada <br />Name:- <br />Order Number: <br /> <br />Number: ST 20160309-01 <br />K <br />u <br />) <br />t <br />v) "8 <br />IP <br />i <br />2 <br />G <br />StL1 <br />* * <br />cool <br />U44 <br />: <br />.1,1 <br />§ v) <br />46 <br />a <br />E_, <br />DW <br />03 <br />o7: z <br />...g, <br />V 0 <br />z <br />E- <br />v <br />4) <br />R. , <br />;I Nt.^ <br />^ <br />— 4) <br />.I <br />3 <br />a <br />ri) <br />E Vi . <br />" 0 <br />0 <br />6 5.t <br />E-, <br />• <br />' 8 <br />cd — <br />g <br />74, G.) <br />r=4 <br />tql <br />p <br />...7.1 v) <br />CV:3 id <br />2 . ,..., <br />0 <br />-..7.: 15 <br />ki .S ,,,, 0 <br />_ <br />a <br />— 0 <br />cel A ..) 2 <br />u ,---, d., c., <br />,E •P '' <br />!IF:, •-• <br />Z c u <br />I <br />San Joaquin County EHD <br />oo <br />a. ri o so — <br />,,, Z <br />"-' ...,_. <br />-c; te-' <br />t ...' <br />c <br />1,1,1 <br />o <br />— f2, o <br />M <br />0 = <br />w <br />.,•:-• <br />z, _ <br />E-, 1 1 <br />-o <br />7, <br />= a. <br />-o 7., <br />_-: <br />Sampler(s) <br />Sampling <br />Compositor <br />,, <br />\ <br />Fee: Pickup Fee:' <br />Setup Date: / / Time: / <br />Lab Number: STK 3-17919 <br />Num <br />Samp Date Location Description Sampled <br />Time <br />Sampled <br />1 <br />Remarks: Relinquished Date: Time: <br />i I - I <br />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