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ENVIRONMENTAL AGRICULTURAL <br />Analytical Chemists <br />Special CHAIN OF CUSTODY <br />P www.fglinc.com <br />Field Copy ti3 of 3) <br />Corporate Offices & Laboratory <br />35731`x, /02/2021 <br />TEST DESCRIPTION - See Re%erse side t� i''mtai 'r. Pre, r%ative and Sampling <br />information <br />Client: San Joaquin County EHD <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 />Address: San Joaquin Co. Environmental Health. Dep <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 />Water Quality Division <br />Attn: Michael Kith <br />3 <br />a <br />186,8 East Hazelton Ave. j <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-3444 Fax: <br />a <br />Contact Person: Michael Kith <br />Q <br />S <br />Name: <br />125Project <br />Purchase Order Number: t J (;, t-7 <br />x 3 <br />w <br />a <br />T <br />O <br />{ <br />Quote Number: <br />o <br />¢ <br />a <br />Z <br />a <br />A <br />Sampler(s) r. <br />I <br />U <br />vwi <br />* <br />O <br />0 <br />p <br />°r„ <br />Sampling Fee: Pickup Fee: <br />.a <br />c <br />y <br />pis <br />Compositor Setup Date: / / Time: /_ <br />E <br />�, z <br />p <br />P4 <br />a <br />O <br />w <br />Lab Number: STK 3-17919 <br />0 <br />0 <br />6 <br />ii <br />0 <br />a <br />H <br />- <br />04, <br />> <br />o� <br />E <br />15, <br />3amp <br />Location Description <br />Date <br />Time <br />Num <br />Sampled <br />Sampled <br />a <br />m <br />m O <br />rn <br />I <br />4 <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Relinquished Date: Time: Relinquished Date: Time: Relinquished <br />l% <br />ceived By: Date: Time: <br />Received By: Date: Time: <br />Received By: Dam: Timr. <br />t <br />I <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 />