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F -GF <br />ELEINVIRONMENTAI,`- ' AGRICU11'1 'RA1, <br />;1n,t11'lic,;,l Ctu:nlists <br />Special <br />CHAiri OF CUSTODY <br />www.fgUnc.com <br />Laboratory Copy, (1 of 3) <br />I 1 I I li ni H.11 ilii III <br />�j�3lI:U_'.Uo._UI: <br />II.JI IJl..11 iCll'I ill\ J.. K�..i .:. .kl� I.i l .uu.uuil. 1't�K,.,ln. ,, i!l'J,U ill:uu� uiuia a„u <br />liens San J aquin County EHD <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />A853 <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />b1 <br />San Luis Obispo, CA 93401 \I� j <br />Visalia, CA 93291 <br />1,' Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 Q <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 />Wdress: San J quin Co. Environmental Health Dep <br />Water uality Division <br />3 <br />_t <br />Attn: odney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />=° <br />c <br />, <br />'hone: (209)468-0331 Fax: <br />w <br />x <br />:ontact Person: Rodney <br />A <br />¢ <br />2 <br />�rEstrada <br />ro ect Name: `` \ <br />J <br />t� <br />r? <br />o <br />'urchase Order Number: <br />r <br />x <br />> <br />_ <br />2uote Number: ST 20160309-01 <br />N <br />E <br />a <br />E <br />OU <br />F- <br />A <br />3ampler(s) <br />4 l <br />«z <br />0 <br />Pickup Fee: Fee: <br />C0 <br />79 <br />CII <br />N <br />ompositor Setup Date: _/_1_ Time: _/_ <br />o <br />rn <br />o <br />u <br />o <br />E <br />w <br />o <br />z <br />a <br />0 <br />p <br />a 'u <br />�� <br />- z <br />�.. <br />U <br />� M <br />v O <br />5x <br />—U <br />w <br />A <br />Q, <br />y <br />E <br />F <br />a <br />ab Number: STK 3 %� 3-17919 <br />(� <br />O <br />c E <br />9 x <br />v <br />amp <br />Location Description <br />Date <br />Time <br />-5 <br />°' <br />Q <br />'' <br />0 <br />g <br />o <br />O <br />v <br />an <br />av <br />u <br />Num <br />Sampled <br />P <br />Sampled <br />P <br />F- <br />o <br />a <br />W <br />at 0 <br />N <br />v- <br />t7 N <br />1L <br />QG <br />DW <br />I <br />I IJ <br />0 <br />temarks: <br />Relinquished Date: Time: <br />wished Da Time: <br />It u(Shed <br />(`)` <br />Date: Time: <br />nay <br />\) <br />R i dB Date: Time: <br />Received By: ate: Time: <br />R eived By: te: . <br />3��/tea a- <br />1 76 <br />10 <br />Corporate Offices & Laboratory <br />Corporation Street <br />Office & Laboratory <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Undo <br />Office & Laboratory <br />3442 Empresa Drive, Suite D (j <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />A853 <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />b1 <br />San Luis Obispo, CA 93401 \I� j <br />Visalia, CA 93291 <br />1,' Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 Q <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 />