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�L <br />ENVIRONMENTAL = AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />Special www.fgUnc.com <br />Field Copy (3 of 3) a <br />0 <br />IIIIII�IIIIIIIIII��I! 1IIIIIIIIIIIIIII1III�IIIIIIIII1I <br />35730:02/06/2017 <br />TEST DESCRIPTION See Reverse side for Container, Preservative and Sampling <br />information <br />'TiClient: San ,Poaquin County EHD <br />Stockton, CA 95215 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />3 <br />Attn: Rodney Estrada <br />Y <br />1868 Fast Hazelton Ave. <br />Stockton, CA 95205 <br />a <br />Phone: (209)468-0331 Fax: <br />w <br />x <br />Contact Person: dney Estrada <br />A <br />V <br />Project Name: <br />' d <br />Purchase Order Number: <br />� <br />Quote Number: ST 20160309-01 <br />y <br />`� <br />a <br />z <br />of <br />00 <br />Sampler(s) <br />U <br />' <br />a ^ <br />°" <br />O <br />�a <br />M <br />o <br />x <br />w <br />Sampling Fee: Pickup Fee: <br />Compositor Setup Date: _/_/_ Time: _/_ <br />a <br />= <br />z <br />O <br />o cn <br />0 <br />v`4 <br />o z <br />ar, <br />z <br />o� <br />U <br />B <br />A <br />U <br />E= <br />Lab Number: STK 3-17919 <br />o <br />N <br />a <br />am <br />=Dat <br />a <br />ro <br />tn <br />F II <br />a <br />° <br />a <br />Samp <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />d <br />o <br />0 <br />o NE <br />0' <br />X <br />E <br />w <br />I <br />G <br />DW <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished D,ur: 1 inre: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Uuir: Time: <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Phone: (805) 392-2000 <br />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 />Fax: (530) 343-3807 <br />Office & 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 />