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CHAIN OF CUSTODY <br /> Special www.fglinc.com <br /> Mtt, NMENTAL AC)RICU ITU RAI, <br /> Laboratory Copy (1 of 3) <br /> ! 35730:02/05/2017 TEST DESCRIPTION - See Reverse side for Container,Preservative and Sampling information <br /> Client: San Joaquin County EHD <br /> Address: San Joaquin Co.Environmental Health Dep <br /> Water Quality Division 2 <br /> Atm:Rodney Estrada <br /> 1858 East Hazelton Ave. 3 L) <br /> Stockton,CA 95205 <br /> a <br /> Phone: (209)468-0331 Fax: x <br /> Contact Person: Rodney Estrada <br /> a <br /> Project Name: O 3 Ll.M S X'4)' <br /> d4), U) A <br /> u w <br /> Purchase Order Number: Gpr (W111,(��� <br /> Quote Number: Sr 20160309-0100 <br /> Sampler(s) w a' <br /> E"o U <br /> o * u j Li 0 <br /> Sampling Fee: Pickup Fee: x iJ <br /> o v o � ern M a <br /> Compositor Setup Date:_!_!_ Time:_/_ E & Z O o4 a .=z O E <br /> v, E C rn o.: 5 z is A <br /> Lab Number: STK � 5 3-17919 0 �n cc <br /> V to h x <br /> 5amp Date Time ES <br /> o U a11�0 o 0 S 9 <br /> Num C. <br /> Location Description Sampled Sampled po 'E �" 15 <br /> c� CIO u— t7 <br /> L), G DW 1 1.1.1 <br /> Remarks: Relinquished Date: Time;.,Relinquished Date: Time: elin ed Date: Time: <br /> ------- ------------- --- <br /> Received By: Date: Time: Received By: Date: Time: Iv y: Date: <br /> 6.0 3 ( �Lel o�v3 tau t � � IK) i <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office&ILaboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Undo 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 San Luis Obispo,CA 93401 Visalia,CA 93291 <br /> Phone:(805)392-2000 Phone:(209)942-0182 Phone:(530)343-5818 Phone:(805)783-2940 Phone:(559)7349473 <br /> Env Fax:(8051525-4172/Aa Fax:(805)392-2063 Fax:(2091942-0423 Fax:(530)343-3807 Fax:(8051783-2912 Fax:(559)734-8435 <br />