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Special CtWN OF CUSTODY <br /> ENVIRONMENTAL AGRICULTURAL <br /> p uniumfgUfnc.c:om <br /> Analytical Chemists Field Copy (3 of 3) <br /> IIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�II�IIIIII 35731:08/02/2021 11 S 11)ESC'RIP110\ See Reverse side for Container,PreserN alive and Sampling -nf)rmauon <br /> Client: San Joaquin County EHD ` <br /> Address: San Joaquin Co.Environmental Health Dep <br /> Water Quality Division 3 a <br /> Attn:Michael Kith F—e <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 fl <br /> a <br /> Phone: (209)468-3444 Fax: w <br /> Contact Person: Michael Kith A <br /> Project Name: ro <br /> Purchase Order Number: U W j O <br /> Quote Number: o <br /> a W a a.Ei F, 07 <br /> Sampler(s) o V) z T O Q <br /> a�.a <br /> 6b O <br /> Sampling Fee: Pickup Fee: <br /> a ° d <br /> Compositor Setup Date: / / Time: / p z O <br /> --- -- v� E 0 C �.. <br /> Lab Number: STK 3-17919 0 C4 iK Q. , <br /> o v F a� O� <br /> Samp Date Time <br /> Location Description T o o <br /> ,, <br /> Num Sampled Sampled � F, p, = as O v)"r <br /> 1 G DW Sub-3 <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Dai Tim <br /> Received By: Date: Time: Received By: Date: Time: Received By: Date: Time: <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E. Lindo 3442 Empresa Drive,Suite D 9415 W. Goshen Avenue <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 San Luis Obispo,CA 93401 Visalia,CA 93291 <br /> Phone:(805)392-2000 Phone:(209)942-0182 Phone: (530)343-5818 Phone:(805)783-2940 Phone: (559)734-9473 <br /> Env Fax:(805)525-4172/Ag Fax:(805)392-2063 Fax: (209)942-0423 Fax:(530)343-3807 Fax:(805)783-2912 Fax: (559)734-8435 <br />