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rfNVIF(ONMENTAL AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />Special www.,fgUnc.com <br />Customer Copy (2 of 3)' <br />11111111111111111111111111111111111111111111111111111111 IN <br />35731:08/02/2021 <br />TEST DESCRIPTION - See Reverse side for Coritainer, Preservative and Sampling information <br />Client: San Joaquin County EHD <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 />Address: San Joaquin Co. Environmental Health Dep <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 />Water Quality Division <br />a <br />Attn: Michael Kith <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />Phone: (209)468-3444 Fax: <br />m <br />�" <br />Contact Person: Michael Kith <br />j! <br />�-�- y v'A fi y� <br />Project Name: <br />vWi <br />rA <br />Purchase Order Number: <br />O <br />Quote Number: <br />N <br />a <br />'g <br />r <br />O <br />V <br />C1 <br />Sampler(s) E <br />a° <br />Sampling Fee: Pickup Fee: <br />.5 <br />c <br />; <br />c <br />Compositor Setup Date: / / Time: / <br />--- -- <br />a <br />z <br />O <br />d Q <br />w <br />Lab Number: STK 3-17919 <br />0 <br />0 <br />�s <br />0 <br />a <br />:: <br />a <br />F <br />m0'0 <br />a� <br />> <br />0- <br />Samp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />H <br />a <br />a0 <br />w O <br />vyi v <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished Date: Tirne <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />CorRorate 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 />