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CIM OF CUSTODY <br />Special wumfgUnc,com <br />Laboratory Copy (1 of 3) <br />1111911111111 MI pill I IN 111111 IN 111 <br />35730:02/06/2017 <br />TEST DESCRIPTION See Reverse side for Container, Preservative and Sampling <br />information <br />Client: San Joaquin County EHD c <br />Santa Paula, CA 93050 <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) 7349473 <br />s <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-0331 Fax: <br />°L <br />Contact Person: Rodney Estrada <br />Lk—+U) <br />Project Name: �"W—Xjh <br />Purchase Order Number: -Trc �1 O �S VL" <br />"� <br />m <br />w <br />` <br />Quote Number: ST 20160309-01 <br />w <br />w <br />* <br />Q <br />a <br />v <br />E <br />E= <br />0O <br />a <br />opo <br />H <br />Sampler(s) M4VM �r&sV <br />O <br />Sampling Fee: Pickup Fee: <br />e <br />• <br />�a <br />a <br />Q0 <br />a <br />$ <br />w <br />o <br />Compositor Setup Date: _/_/_ Time: _/_ <br />Q <br />E <br />0 <br />o <br />z° <br />a <br />p <br />o�i— <br />vq <br />c <br />Lab Number: STK 13-17919 <br />g� <br />'� :, <br />`= c <br />c <br />x <br />amp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />p <br />°' <br />'� <br />F <br />o <br />0. <br />m <br />W <br />E <br />ls7 O <br />N <br />U <br />u n <br />0 ev <br />v 0, <br />Is. =: <br />u <br />Ix. <br />u <br />W <br />I <br />( Z <br />USI <br />G <br />DW <br />I <br />1,1,1 <br />�,�'51illit <br />to -.61 <br />Remarks: <br />Relinquished Date: Time: <br />Rel' ed ate: Time: Relinquished Date: Time: <br />IRevBy: Date: Time: <br />"s19 /;e5,/ <br />Received By: D te: Time: Reset ed By: Dale: Time: <br />� 9 ��1 <br />1140 <br />O S S <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Office & Laboratory <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Undo <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93050 <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) 7349473 <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 />