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ENVIRONMENTAL -= - AGRICULTURAL Analytical Chemists Special CHAIN OF CUSTODY www.fgUnc.com Field Copy (3 of 3) CorporateOffices & Laboratory 35731:08/02/2021 TEST DESCRIPTION See Reverse side for Container, Preservative and Sampling information Client: San Joaquin County EHD Office & Laboratory 853 Corporation Street 2500 Stagecoach Road 563 E. Lindo 3442 Empresa Drive, Suite D 9415 W. Goshen Avenue Santa Paula, CA 93060 Stockton, CA 95215 Chico, CA 95926 San Luis Obispo, CA 93401 Visalia, CA 93291 Phone: (805) 392-2000 Phone: (209) 942-0182 Phone: (530) 343-5818 Phone: (805) 783-2940 Address: San Joaquin Co. Environmental Health Dep 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 Water Quality Division :a Attn: Michael Kith 3 1868 East Hazelton Ave. Stockton, CA 95205 3 Phone: (209)468-3444 Fax: x Contact Person: Michael Kith Project Name: i a Purchase Order Number: x j 3 > Quote Number: z ' U Ca Sampler(s) Sampling Fee: Pickup Fee: v e < Compositor Setup Date: / / Time: / z p w _ a L Lab Number: STK 3-17919 `o 62 a; a — > Q H ao oL) ISamp Location Description Date. Time I`Num Sampled Sampled E✓ a p m O % — --- ' I G DW Sub -3 I Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: Received By: Date: Time: Received By: Date: Time: Received By: Date: Time: L CorporateOffices & Laboratory Office & Laboratory Office & Laboratory Office & Laboratory Office & Laboratory 853 Corporation Street 2500 Stagecoach Road 563 E. Lindo 3442 Empresa Drive, Suite D 9415 W. Goshen Avenue Santa Paula, CA 93060 Stockton, CA 95215 Chico, CA 95926 San Luis Obispo, CA 93401 Visalia, CA 93291 Phone: (805) 392-2000 Phone: (209) 942-0182 Phone: (530) 343-5818 Phone: (805) 783-2940 Phone: (559) 734-9473 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