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ENVIRONMENTAL AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />Special www rgiinc = <br />Cust6mer Copy (2 of 3) <br />m ; <br />Corporate Offices & Laboratory <br />35730:02/06!2017 <br />TEST DESCRIPTION' See Reverse side for Container, Preservative and Sampling information <br />Zlienr San Joaq"i 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 />Phone: (559) 734-9473 <br />Address: San Joaquin Co. Environmental Health Dep <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: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-0331 Fax: <br />w <br />a <br />Contact Person: Rodney Estrada <br />Project Name: <br />Purchase Order Number: <br />Quote Number: ST 20160309-01 <br />y <br />o <br />v <br />vi <br />z <br />`� <br />O�y <br />N <br />00A <br />a <br />a <br />Sampler(s) \ ��\� .r <br />x <br />p <br />Sampling Fee: Pickup Fee: <br />°' <br />a� rt <br />? <br />M <br />"" <br />O <br />W <br />o <br />Compositor Setup Date: /_/_ Time: _/ <br />0. <br />`E <br />0 <br />.y'O <br />to <br />z <br />ii <br />O <br />e N <br />M <br />t(n <br />o z <br />U <br />z <br />�-. <br />w <br />lu <br />y <br />Q <br />p <br />E <br />fl <br />Lab Number: STK (( 3-17919 <br />sa <br />'� <br />0 <br />v <br />Date <br />Time <br />5ampp <br />Num <br />Location Description <br />Sampled <br />Sampled <br />T <br />F <br />o <br />a <br />ro <br />co <br />5 <br />a1 O <br />0 <br />v <br />,��, <br />c7 c� <br />a <br />_: <br />i <br />u <br />I <br />G <br />DW <br />l <br />I'Ll <br />Remarks: <br />Relinquished Date: lime: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <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 />