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FL7--v-, <br />\n7ihtiCt31 Chcniisis <br />Special <br />4 <br />4 tCHAIN OF CUSTODY <br />I . wuw.rgUnc.com <br />Laboratory CAp•Y (I of 3) <br />1111111111111111111111111111111111111111111111111111111 •35730:02/06/2017 <br />TEST DESCRIPTION - See Reverse side for Container. Preservative and Sampling <br />information <br />'tient: San Joaquin County Elie <br />Office & Lab ratory <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) 5251172 / 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 />address: Sa Joaquin Co. Environmental Health Dep <br />Wr Quality Division <br />3 <br />g <br />AtQt: Rodney Estrada <br />1868 East Hazelton Ave. <br />u <br />Stockton, CA 95205 <br />3 <br />a <br />'hone: (209)'168-0331 Fax: <br />_ <br />* <br />x <br />u <br />x <br />'ontact Person: Rodney Estrada <br />'ro Name: <br />cn <br />ect <br />urchase Order Number:LU <br />)uote Number: ST 20160309-01 <br />c <br />ti <br />z <br />>, <br />] <br />N <br />A <br />;ampler(s) r / /► <br />iampling Fee: Pickup Fee: <br />c <br />? <br />? <br />$ <br />aF- <br />ompositor Setup Date: _/_/_ Time: _/_ <br />C,v <br />E <br />rn <br />0 <br />Q <br />E <br />2 <br />o <br />z <br />ii <br />p <br />e 'v <br />c rn <br />a_�i <br />_ z <br />c— <br />V o` <br />v O <br />g z <br />-0Z <br />v .. <br />iz <br />y= <br />v <br />A <br />s <br />E <br />(_ <br />X <br />ab Number: STK Z 3-17919 <br />Location Description <br />Date <br />Time <br />°1 <br />o <br />v oamp <br />Yum <br />Sampled <br />Sampled <br />F- <br />4O <br />O <br />I <br />w <br />2 <br />I& <br />G <br />DW <br />I <br />1,1,1 <br />It lkt <br />; fo <br />temarks: <br />Relinquished Date: Time: <br />Relin Date: Time: <br />Relinquished Date: Time: <br />/ � �( -`v <br />Iq <br />!� 1 1 IM <br />(/ / ( <br />1 V `v 1I <br />Received Date: Time: <br />Recei d B ate: Time: <br />Received By: Date: Time: <br />It , q11t i <br />1q 'ZZ ►its <br />I (-Dn \L/ \J j, <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Office & LaboratA <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Lindo <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />Office & Lab ratory <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) 5251172 / 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 />