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ENVIRONMENTAL AGRICULTURAL <br />Analytical Chemists <br />Special <br />CHAIN OF CUSTODY <br />www.fgUnc.com <br />Field Copy, 3 of 3) <br />s <br />=.1 <br />Y d <br />357„0, -0t, 20p <br />TEST DESCRIPTION See Reverse side for Contain,., .Preset #tive and SaSnpling <br />information <br />Clienb.o San JoaqCounty 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 />Phone: (559) 734-9473 <br />Addrep San Joaquin Co. Environmental Health Dep <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />, a, <br />Water Quality Division <br />3 <br />Atm: Rodney .Estrada <br />> <br />1868 East Ha' elton Ave. <br />� <br />Stockton, CA 95205 <br />3 <br />Phone: (209)468-0331 Fax: <br />W <br />GO <br />Contact Person: Rodney Estrada <br />0 <br />Project Name: <br />C7 <br />a <br />Purchase Order Number: <br />3 <br />p <br />x <br />Quote Number: ST 20160309-0100 <br />a <br />o <br />w <br />a <br />Z <br />A <br />Sampler(s) <br />U <br />C4 <br />a <br />x <br />inn <br />0 <br />a <br />5 <br />Q O <br />a <br />W <br />Sampling Fee: Pickup Fee: <br />s <br />'o <br />rr <br />o <br />Compositor Setup Date: / / Time: ! <br />--- -- <br />Q <br />E <br />z <br />O a a <br />o� <br />o. <br />`� <br />'= z <br />o <br />U <br />M <br />O <br />[z <br />x <br />z <br />iii <br />Q <br />x <br />H <br />x <br />Lab Number: STK 3-17919 <br />0 <br />6 <br />w!I <br />a <br />o <br />cd. <br />o <br />o <br />N <br />�, a <br />d <br />Samp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />G <br />4 <br />DW <br />a <br />'do <br />m w O <br />U <br />O C4 <br />w <br />1 <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Ooroorate 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 />