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ENVIRONMENTAL -='" AGRICULTURAL <br />Analytical Chemists <br />CHM OF CUSTODY <br />Special www.fgUne.com <br />Field Copy (3 of 3) <br />S <br />iIIIIIIIIIIiIIIIIIiIIIIIIIII <br />^;I:Uti U_' _'0_'t <br />1 I_til DESLRIPIION See Re%erse side fur Container. Presenauve and ampling mtiinrxuun <br />Client: San Joaouin 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 />3 <br />a <br />Attn: Michael Kith <br />w <br />1868 East Hazelton Ave. <br />g <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-3444 Fax: <br />x <br />Contact Person: Michael Kith <br />Project Name: <br />Purchase Order Number: <br />V <br />W <br />3 <br />in <br />a <br />OC <br />Quote Number. <br />o <br />w <br />< <br />z <br />� <br />a <br />a <br />U <br />A <br />Sampler(s) <br />ao <br />�o <br />7 <br />Sampling Fee: Pickup Fee: <br />c <br />d <br />Compositor Setup Date: _/_/_ Time: _/_ <br />c <br />o <br />z <br />O <br />C a <br />W <br />Lab Number: STK 3-17919 <br />0 <br />o <br />o <br />a <br />o <br />o <br />H <br />�O <br />15 <br />> <br />DC7 <br />a e <br />SamP <br />Date <br />Time <br />Location Description <br />Sampled <br />Sampled <br />E.., <br />p <br />=0 <br />Num <br />y "t <br />I <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Relinquished Date: Time: Relinquished Date: Time: Relinquished Dace: Timr: <br />L__j <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: lime: <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 />