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ENVIRONMENTAL AGRICULTURAL <br />Analytical Chemists <br />Special <br />CHAIN OF CUSTODY <br />www.fglinc.com <br />Field Copy (3 of 3) <br />Corporate Offices & Laboratory <br />35731:08!02/2021 <br />TEST DESCRIPTION -See Reverse si, lc for Container, Preservative and Sampling information <br />_ <br />Client: San Joaquin 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 />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />a <br />Phone: (209)468-3444 Fax: <br />C7 <br />W <br />Contact Person: Michael Kith <br />Q <br />P4 <br />Project Name: - <br />hCd <br />Purchase Order Number:> <br />to <br />Quote Number: <br />.. <br />o <br />a <br />> <br />O <br />U <br />Q <br />Sampler(s) <br />4n <br />a <br />Sampling Fee: Pickup Fee: <br />5 <br />t'" <br />❑ <br />; <br />o <br />Q <br />Compositor Setup Date: _/_/_ Time: _/_ <br />a <br />qa <br />z <br />O <br />a a <br />W <br />Lab Number: STK 3-17919 <br />0 <br />v <br />10� <br />0 <br />a <br />a <br />ro .. <br />amp <br />Location Description <br />Date <br />Time <br />c <br />b <br />'� 0 <br />p <br />p <br />Num <br />Sampled <br />Sampled <br />� <br />H <br />a <br />m <br />w <br />I <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />inx: <br />Relinquished Dar: Tim": <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Darr: T -mit:: <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 />