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Cl ffiri OF CUSTODY <br />Special www.fgUnc.com <br />Laboratory Copy (1 of 3) <br />Illlllllllllllllillllllllllllllllllf I <br />35731:08/02/2021 <br />[INVIRONMENTAL <br />AGRICUL MAL <br />Anailviical Chemists <br />Cl ffiri OF CUSTODY <br />Special www.fgUnc.com <br />Laboratory Copy (1 of 3) <br />Illlllllllllllllillllllllllllllllllf I <br />35731:08/02/2021 <br />+ TEST DESCRIPTION See Reverse side for CUnlamer. Preservative and Sampling IntormahUn <br />--tient: San Joaquin County EHD <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Undo <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 / Aq 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 />a <br />Attn: Michael Kith <br />1868 Fast Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />c <br />?hone: (209)468-3444 Fax: <br />t? <br />w <br />3r <br />-ontact Person: Michael Kith <br />4P "wl1A, <br />?roject Name: ms -'L <br />?urchase Order Number: <br />U <br />cu <br />3 <br />¢ <br />lu <br />v <br />> <br />quote Number. <br />o <br />� <br />Z <br />E <br />0a <br />V <br />A <br />Sampler(s) (� <br />Sampling Fee: Pickup Fee: <br />e <br />o <br />C <br />O <br />•� y <br />o A <br />Compositor Setup Date: /_!_ Time-/ <br />E <br />c <br />z <br />O <br />a <br />w <br />0 <br />a <br />a <br />m- <br />'a j <br />Lab Number: STK �(p 3-17919 <br />o <br />F <br />a0 <br />- <br />p <br />amp <br />Location Description <br />Date <br />Sampled <br />Time <br />Sampled <br />•S <br />p <br />a <br />= <br />Num <br />m <br />v <br />m p <br />o E <br />� a <br />E'` <br />1 <br />G <br />DW <br />Sub -3 <br />temarks: <br />Reli quished Date: Time:fished <br />`Da Time: <br />Relinquished Date: Time: <br />3 (q �2 4: <br />�1,;7 as 1.746 <br />By: <br />R% Date: Time: <br />Received By: Date: Time: <br />_'7 <br />: <br />Received By: Date: Time: <br />'�/' T ��o�a /ooa <br />/ 7ey <br />�) I <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office A Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Undo <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 / Aq 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 />