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CHAIN OF CUSTODY <br /> s Special www.fg <br /> O linc.com <br /> Analytical Clu'MiSIS Lab njory Copy (1 of 3) <br /> 35731:08 102/2021 TEST DESCRIPTION - See Reverse side for Contained;Preservative and Sampling information <br />;'Client: San Joaquin County EHD <br /> ddress: San Joaquin Co. Environmental Health Dep � � <br /> Water Quality Division 3 a <br /> Attn: Michael Kith <br /> 1868 East Hazelton Ave. <br /> Stockton,CA 95205 3 n. <br /> Phone: (209)468-3444 Fax: <br /> Contact Person: Michael Kith Q <br /> Project Name: °= ° cc-- <br /> Purchase Order Number: a > tw 0 <br /> 104 <br /> Quote Number: G414 N N ^l � a U <br /> CL .. E <br /> Sampler(s) c w z E a0 A <br /> p. <br /> 6 a O e <br /> Sampling Fee: Pickup Fee: ° <br /> ES <br /> CL. Q <br /> Compositor Setup Date: / / Time: / E a, z O a �, w <br /> v� E E <br /> Lab Number: STK 3-17919 <br /> lamp Date Time -SE <br /> Num Location Description Sampled Sampled 4> E~ a°, Mp <br /> WO <br /> G DW Sub-3 <br /> Remarks: Relinquished Date: Time: RelinquishedDate Time: Relinquished Date: Time: <br /> Z5 ZZ l 79 <br /> Received B Date: Time: Received y: ate- Time: eceived By: Date: Time: <br /> Corporate Offices&Laboratory ioratory Office&Laboratory Office&Laboratory Office&Laboratory <br /> 853 Corporation Street / 2500 Stagecoach Road 563 E.Undo 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93060 V 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/AQ Fax:(805)392-2063 Fax:(209)942-0423 Fax:(530)343-3807 Fax:(805)783-2912 Fax:(559)734-8435 <br />