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ENVIRONMENTAL = AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />Special www.fgUnc.com <br />Field Copy (3 of 3) <br />Corporate Offices & Laboratory Office & 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 />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 />35731:08/02/2021 <br />TEST DESCRIPTION <br />- See Reverse <br />side <br />for Container, <br />Preservative <br />and <br />Sampling <br />information <br />Cligat: San Joaquin County EHD <br />! <br />Address: San Jgaquin Co. Environmental �lealth Dep <br />Water Quality Division <br />a <br />Attn: Michael Kith <br />m <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />�, <br />Phone: (209)468-3444 Fax: <br />w <br />a <br />Contact Person: Michael Kith <br />d <br />_ <br />Project Name: <br />a <br />rn <br />Purchase Order Number: <br />w <br />3 <br />a <br />T <br />Quote Number: <br />a <br />o <br />a <br />W <br />on <br />aw <br />z <br />F <br />> <br />O <br />Q <br />Samplers) <br />U <br />* <br />^? <br />CO) <br />Ev a <br />v <br />Sampling Fee: Pickup Fee: <br />�o <br />Compositor Setup Date: _/_/_ Time: _/_ <br />Ei <br />a <br />z <br />O <br />d ¢ <br />0 <br />w <br />Lab Number: STK 3-17919 <br />0 <br />5> <br />> <br />o <br />o <br />d <br />_° <br />n <br />F <br />a <br />O_, <br />Samp <br />Num <br />Location Description <br />Date <br />Sampled <br />Time <br />Sampled <br />F <br />o <br />p <br />ro <br />w O <br />o <br />60 v <br />I <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Timr: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Corporate Offices & Laboratory Office & 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 />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 />