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Remarks: - <br />(1) 2°' a <br />9 'Lab Number: STK 3-17919 Client: San Joaquin County EHD Address: San Joaquin Co. Environmental Health Dep Water Quality Division Attn: Michael Kith 1868 East HazeIton Ave. Stockton, CA 95205 Phone: (209)468-3444 Fax: Contact Person: Michael Kith Project Name: Purchase Order Number: Quote Number: —1 location Description ir(s) ng Fee: Pickup Ft isitor Setup Date: <br />- <br />— <br />= ...—_ _ = <br />_. .._._ — <br />= <br />--- Date Sampled Time Sampled ;a <br />:..-. <br />H <br />= <br />F: <br />_ <br />H <br />Method of Sampling: Composite(C) Grab(G) <br />cF.' Type of Sample **SEE REVERSE SIDE** ---1 <br />.. <br />-._:.cz <br />Potable(P) Non-Potable(NP) Ag Water(AgW) oo <br />-6 I,.. <br />Bacti Type: Other(0) System(SYS) Source(SR) Waste(W) co i.., <br />Bacti Reason: Routine(ROUT) Repeat(RPT) Replace(RPL) <br />Other(0) Special(SPL) <br />.- <br />cr. <br />a- <br />`-•' TEST DESCRIPTION - See Reverse side for Container. Preservative and Sampling information Lu Received By: Date: Time: Relinquished Date: Time: Received By: Date: Time: Relinquished Date: Time: otetoqei aow el 'S' 801110 saowo amo co <br />-n Co <br />00 <br />(77 <br />CJJ <br />N.) <br />01