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7,,7�A�n�alytical <br />L — AGRICULTURAL <br />emists <br />Special CHAIN OF CUSTODY <br />P www.fglinc.com <br />k Fid&d Copy (3 of 3) <br />111111111 IN <br />357 x:02/06201 ":' <br />TEST DESCRIPTION' See Reverse sideVor Con¢ aper. Presertative and Sampling <br />information <br />Client: 1 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 />; <br />Water Quality Division= <br />3 <br />a <br />Attn: Rodney Estrada <br />04 <br />1'68 East Hazelton Ave. <br />CA 95205 <br />3 <br />Stockton, <br />� <br />a <br />a <br />Phone: (209)468-0331 Fax: <br />w <br />Contact Person: Rodney Estrada <br />A <br />¢ <br />2 <br />Project Name: <br />C7 <br />a <br />V <br />Purchase Order Number: <br />w <br />3 <br />¢ <br />h <br />a <br />a <br />ua <br />Quote Number: ST 20160309-0100 <br />o <br />w <br />vi <br />a <br />Z <br />F <br />O <br />Q <br />Samplers) ' ` / <br />U <br />x <br />p" <br />Sampling Fee: Pickup Fee:5 <br />a <br />; <br />o @ <br />ti <br />N <br />Q <br />Compositor Setup Date: /—/ Time: _/_ <br />— <br />@ <br />0 <br />a <br />z <br />ii' <br />O <br />a <br />¢ <br />o� <br />-6 <br />= z <br />a <br />U� <br />M <br />v z <br />Gx <br />w <br />n� <br />A <br />d <br />F <br />Lab Number: STK 3-17919 <br />Q <br />c <br />5 <br />O <br />5� <br />t <br />o <br />°� a <br />Samp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />F. <br />a <br />x1 <br />cq O <br />N <br />U -� <br />ani <br />O N <br />is. <br />w <br />w <br />G <br />DW <br />1 <br />nit <br />Remarks: <br />Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br />ReceivedB Date- Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />�� <br />��l rI,J n a6 <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 />