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(FCL i <br />ENVIROMMIAL"=—' AGIZICUI:MRAL <br />\unlvliCnl Chcmisis <br />CHMN OF CUSTODY <br />Special www.fgUnc.com <br />Laboratory Copy (1 of 3) <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />35730:02/06/2017 <br />TEST DESCRIPTION - See Reverse side for Container. Preservative anis Sampling information <br />--lient: San Jpaquin County EHD <br />j� Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />%=Fhn(e <br />Phone: (805) 7F� ) 4Env <br />Fax. (805) 525-4172 / Ag Fax. (805) 392-2063 <br />Fax. (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-29129) 84 <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />a <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />0 <br />Phone: (209)468-0331 Fax: <br />c7 <br />w <br />y <br />x <br />�ontact Person: Rodney Estrada <br />Q <br />Project Name: Z� ��� �LQ h�A\�� l"(1t;1'+� <br />C7 <br />a <br />rn <br />1 <br />Purchase Order Number: <br />¢ <br />w <br />quote Number: ST 20160309-01 <br />$ <br />E <br />w <br />z <br />E <br />> <br />E <br />O <br />F <br />A <br />Sampler(s) <br />U <br />= <br />a <br />M <br />� <br />Sampling Fee: _ Pickup Fee: <br />Compositor Setup Date: /_/_ Time: _/_ <br />E <br />o <br />a <br />rn <br />o <br />z <br />u0 .0 <br />p <br />F <br />'-' <br />= <br />a a <br />A <br />= L <br />�' z <br />U <br />� <br />=;amp <br />oLocation <br />v O <br />5z <br />x= <br />cv <br />,9—, z <br />iz <br />A <br />A <br />x <br />E <br />E - <br />x <br />Lab Number: STK �a3D' �p 3-17919 <br />Date <br />Time <br />Num <br />Description <br />Sampled <br />Sampled <br />" <br />07 <br />M 0 <br />o� <br />U= <br />C7N <br />w_: <br />w <br />is. <br />1 <br />11` <br />W <br />G <br />DW <br />1 <br />l.lrp <br />y��►�� <br />Q�•�J <br />Remarks: <br />Relinquished Date: Time: <br />R shed Date: Time: <br />inq ished Datc.L Time: <br />Re/ Dat : Time: <br />Received By: Date: Time: <br />Re i <br />B Ite: TT <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />Office & Laborittory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />Office & Laboratory Office & Laboratory <br />3442 Empresa Dnve S to D Goshen enu <br />San Luis Obis9 <br />j� Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />%=Fhn(e <br />Phone: (805) 7F� ) 4Env <br />Fax. (805) 525-4172 / Ag Fax. (805) 392-2063 <br />Fax. (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-29129) 84 <br />