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ENVIRONMENTAL =' AGRICULTURAL <br />Analytical Chemists <br />Special CI- MN OF CUSTODY <br />P www.fgUnc.com • <br />Customer Copy (2 of 3) <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />35731:08/02/2021 <br />FEST DESCRIPTION - See Reverse side tier Container, Pre.ervative and Sampling information <br />Cliept: San Joaquin County EHD <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />c <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 />Address: San Joaquin Co. Environmental Health Pep <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Water Quality Division <br />Attn: Michael Kith <br />o. <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />c <br />Phone: (209)468-3444 Fax: <br />a <br />Contact Person: Michael Kith <br />Q <br />Q <br />Project Name: l z L <br />Cn <br />v� <br />Purchase Order Number: <br />U <br />W <br />3 <br />in <br />°� <br />y <br />T <br />2 <br />Quote Number: <br />Y <br />N <br />o <br />a <br />o <br />W <br />p= <br />w <br />vwi <br />Q <br />a <br />z <br />v <br />T <br />E: <br />O <br />a <br />U <br />ca <br />A <br />Samplers) <br />* <br />,o <br />Sampling Fee: Pickup Fee: <br />Compositor Setup Date: / / Time: / <br />z <br />O <br />p <br />w <br />Lab Number: STK 3-17919 <br />0436 <br />0 <br />C <br />T <br />a <br />o <br />a <br />U.S <br />p <br />9 o <br />Samp <br />Location Description <br />Date <br />Time <br />Num <br />Sampled <br />Sampled <br />F. <br />p <br />m <br />ca O <br />v) "t <br />I <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Rchngkikhed D;ue: rime: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Received Bq: Date: `rime: <br />Received By: Date: Time: <br />Received By: Daae: "lime: <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 />