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l <br />ENVIR0 MENTAL — AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />Special www.fglinc.com <br />Customer Copy (2 of 3) <br />Corporate Offices & Laboratory <br />35730:02/06/2017 <br />TEST DESCRIPTION See Reverse side for Container, Preservative 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 />Phone: (559) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Address: San Joaquin Co. Environmental Health Dep <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Water Quality Division <br />3 <br />a <br />Attn: Rodney Estrada <br />a <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />n <br />Phone: (209)468-0331 Fax: <br />w <br />3 <br />lu <br />Contact Person: Rodney Estrada <br />M <br />Q <br />bD <br />¢ <br />y <br />S <br />Project Name: <br />C <br />� <br />v: <br />x <br />Purchase Order Number: <br />C <br />y <br />w <br />x <br />Quote Number: ST 20160309-01 <br />E <br />w <br />z <br />E0 <br />o <br />CC <br />H <br />Ca <br />Sampler(s) <br />U <br />N <br />m <br />Cn <br />a <br />° <br />O <br />0 <br />O <br />ca <br />d°1 <br />O <br />x <br />W <br />Sampling Fee: Pickup Fee: <br />c <br />o <br />a <br />Compositor Setup Date: / Time: /_ <br />E <br />z <br />O <br />0 <br />o z <br />c <br />w <br />Q <br />F= <br />Lab Number: STK 3-17919 <br />0 <br />a <br />a <br />R <br />U <br />x <br />x <br />x <br />0 <br />E <br />Samp <br />Date <br />Time <br />Num <br />Location Descript <br />Sampled <br />Sampled <br />� <br />a. <br />6 <br />°i <br />U� <br />C7N <br />w-: <br />iw <br />s <br />I <br />G <br />DW <br />Remarks: <br />Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <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 />