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Special CHAIN OF CUSTODY <br />P www.fglinc.com <br />Laboratory Copy (L of 3) <br />INN 41 Till 11111111111� 11!111E <br />3S731:08,02,2021 <br />11.51 W.S( I21P11(J\ Sec Kc\cnc >iJc Iot C'ouuainct. 1'ICaCI\.Illi .utd Jaiuplutg, utl.nnt.unn <br />'liens: San Jgaquin County EHD <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />< <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />/�J Jv 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 />r..,, ems..• ranst aor-e177 I A. c.„• tanrN coy-9nwi <br />Fov i9no) gag-nd')'A <br />Fav• rFlm aaq-gRm <br />FaY• MR1 7A1 -9q19 <br />Wdress: San Jqaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Michael Kith <br />a <br />1868 East Hazelton Ave. <br />m <br />Stockton, CA 95205 <br />3 <br />a <br />'hone: (209)468-3444 Fax: <br />a <br />.ontact Person: Michael Kith <br />A <br />'roject Name: 2(. q vi �-A4T <br />vi <br />H <br />w <br />'urchase Order Number:v <br />�' 22� <br />04 <br />°` <br />A. <br />uote Number: <br />y <br />o <br />u <br />x <br />Z <br />0 <br />E <br />T <br />N <br />a0 <br />w a <br />A. <br />U <br />U <br />A <br />iampler(s) <br />-t�Co (�,` <br />Z <br />Sampling Fee: Pickup Fee: <br />o <br />O <br />,= <br />•a y <br />:ompositor Setup Date: / / Time: 1 <br />--- -- <br />nQ <br />0 <br />a <br />W)a <br />z <br />c <br />O <br />a, <br />w <br />Lab Number: STK 3-17919 <br />Za <br />aO <br />0 <br />amp <br />kation Description <br />Date <br />Sampled <br />Time <br />Sampled <br />-S <br />M <br />$ <br />M <br />u <br />w O <br />.n E <br />� <br />Num <br />E; <br />a° <br />rn <br />G <br />DW <br />Sub -3 <br />temarks: <br />Relinquished Date: Time: <br />Relinquished Time: <br />Relinquished Date: Time: <br />10 <br />Received By: Date: Time: <br />Received By: to Time: <br />Received By: Date: Time: <br />W-- 3 % -Z I qg,� <br />& 22 aov <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Office & Laboratory <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Undo�i <br />Office & Laboratory <br />JQ��jZ 3442 Empresa Drive, Suite D <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />/�J Jv 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 />r..,, ems..• ranst aor-e177 I A. c.„• tanrN coy-9nwi <br />Fov i9no) gag-nd')'A <br />Fav• rFlm aaq-gRm <br />FaY• MR1 7A1 -9q19 <br />Fav• /l;Sg1 75til-Rd-S <br />