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CIHMN OF CUSTODY <br />Special www.fgUnc.com <br />Customer Copy (2 of 3) <br />35731:02/06/2017 <br />TEST DESCRIPTION See Reverse side for Container, Preservative and Sampling information s <br />ENVIRONMENTAL <br />— <br />Analytical Chemists <br />AGRICULTURAL <br />CIHMN OF CUSTODY <br />Special www.fgUnc.com <br />Customer Copy (2 of 3) <br />Corporate Offices & Laboratory Office & Laboratory <br />853 Corporation Street 2500 Stagecoach Road <br />Santa Paula, CA 93060 Stockton, CA 95215 <br />Phone: (805) 392-2000 Phone: (209) 942-0182 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />35731:02/06/2017 <br />TEST DESCRIPTION See Reverse side for Container, Preservative and Sampling information s <br />Client: San Joaquin County EHD <br />¢ <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />a <br />Attn: Rodney Estrada <br />3 <br />a <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />$ <br />c <br />Phone: (209)468-0331 Fax: <br />Contact Person: Rodney Estrada <br />C"DA <br />¢ <br />2 <br />Project Name: �_ . '� i r I,.. -. i r / i �, <br />C7 <br />rwn <br />� <br />ro <br />x <br />Purchase Order Number: <br />w <br />3 <br />a <br />Quote Number: ST 20160309-01 <br />N <br />o <br />x <br />vwi <br />¢ <br />z <br />O <br />Sampler(s) <br />c <br />o <br />p" <br />O <br />ga <br />Sampling Fee: Pickup Fee:. <br />G <br />; <br />o <br />a <br />Compositor Setup Date: _/_/_ Time: _/_ <br />a <br />E <br />z <br />O <br />a a <br />o <br />P4 <br />A <br />Lab Number: STK 3-17919 <br />o <br />rn <br />a <br />o. <br />O <br />Samp <br />Location Description <br />Date <br />Time <br />sa <br />a <br />o <br />$ <br />a o <br />Num <br />Sampled <br />Sampled <br />F. <br />a <br />oo <br />w O <br />w <br />0 <br />Travel Blank <br />G <br />LBW <br />4 <br />1 <br />G <br />DW <br />i <br />Remarks: <br />Relinquished Dare: Time: <br />Relinquished Date: Time: <br />Relinquished llatc: I'imr: <br />Received By: Darc: Timc: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Corporate Offices & Laboratory Office & Laboratory <br />853 Corporation Street 2500 Stagecoach Road <br />Santa Paula, CA 93060 Stockton, CA 95215 <br />Phone: (805) 392-2000 Phone: (209) 942-0182 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />