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CHAIN OF CUSTODY <br />Special www.fgUnc.com <br />Customer Copy (2 of 3) <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII,IIIIIIIIIIIIIIIIIIIII�I <br />35730:02/06/2017 <br />TEST DESCRIPTION Set; Reverse side for Container. Preservative and Sampling information <br />CClient: San Joaquin County EHD I <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 />Address: San Joaquin Co. Environmental Health Dep <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Water Quality Division <br />w <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-0331 Fax: <br />o <br />Contact Person: Rodney Estrada <br />Project Name: =�' '. ` ) % �p h(� Lf1 <br />wo <br />a <br />GO <br />x <br />Purchase Order Number: <br />Quote Number: Sr 20160309-01 <br />y <br />a <br />Q <br />til <br />CL <br />z <br />E <br />�; <br />F <br />o <br />oc <br />H <br />Q <br />Sampler(s) <br />� <br />,a <br />Sampling Fee: Pickup Fee: <br />5 <br />; <br />c <br />° r4 <br />a <br />Compositor Setup Date: Time: /_ <br />d <br />ya��i <br />z <br />O <br />cNa <br />ca cn <br />z <br />b z <br />n� <br />E <br />_/_/_ <br />`E <br />d y <br />0 <br />o z <br />G <br />ii <br />Q <br />Lab Number: STK 3-17919 <br />L <br />5 <br />a <br />lz <br />� <br />v <br />°' <br />a <br />o <br />- a <br />� <br />c o <br />" r. <br />H II <br />x71 <br />x <br />0. <br />x <br />a <br />Samp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />a° <br />rrA <br />O <br />U <br />C7 N <br />LZ a <br />u <br />I <br />G <br />DW <br />Remarks: <br />Relinquished Date: 'Gime: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Cimc: <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 />