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Special <br />CIiA N OF CUSTODY <br />www. fglinc. com <br />Customer Copy (2 of 3) <br />Corporate Offices & Laboratory <br />35731:02/06/2017 <br />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 <br />a <br />Attn: Rodney Estrada <br />y <br />1868 East Hazelton Ave. <br />L <br />Stockton, CA 95205 <br />Phone: (209)468-0331 Fax: <br />Contact Person: Rodney Estrada <br />Q <br />d <br />pF <br />wi <br />Project Name: <br />v°, <br />Purchase Order Number: <br />Quote Number: ST 20160309-01 <br />o <br />a <br />w <br />a <br />E <br />Sampler(s) <br />z <br />T <br />o <br />Cn <br />O <br />coo <br />oO <br />Sampling Fee: Pickup Fee: <br />° <br />o <br />a <br />o <br />o <br />c <br />Compositor Setup Date: _/ /_ Time: / <br />E <br />n <br />°3 <br />E <br />z <br />O <br />o <br />oCa <br />Lab Number: STK 3-17919 <br />0 <br />� <br />a <br />a <br />v O <br />0 <br />o� <br />Samp <br />Date <br />Time <br />�, <br />o <br />M <br />'C <br />a o <br />Num <br />Location Description <br />Sampled <br />Sampled <br />� <br />p <br />w <br />F <br />a <br />�q <br />0 <br />Travel Blank <br />G <br />LBW <br />4 <br />1 <br />G <br />DW <br />4 <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 />Office 8 Laboratory <br />853 Corporation Street 2500 Stagecoach Road <br />Santa Paula, CA 93060 Stockton, CA 95215 <br />Phone: (805) 392-2000 Phone: (209) 942-0182 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />(530) 343-3807 <br />Office 8. Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559)734-9473 <br />Fax: (559)734-8435 <br />