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=S <br />' FGL <br />VIROMILNTALAGRICl1LTURAL <br />; nalytic;ll chi wises <br />S ecial CHAIN OF CUSTODY <br />P i WWW.fgUnc.COM <br />Llboratory Copy (1 of 3) <br />,- <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />3 731'08/02/2021 <br />'1'ES•r DESCRIPTION See Reverse side fur CMttai?7.. Preservative and Sampling information <br />'tient: San Joaquin County EHD <br />Office & Laboratory <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) 5254172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />>,ddress: San Joaquin Cu. Environmental Health Dep <br />v: <br />A <br />Water Quality Division <br />D <br />3 <br />Attn: Michael Kith <br />a <br />1868 East Hazelton Ave. <br />Stockton, CA 95205—° <br />3 <br />a <br />'hone: (209)468-3444 Fax: <br />c7 <br />w <br />3 <br />N <br />a <br />-ontact Person: Michael Kith <br />J! <br />A <br />'roject Name:2�Y� l3 / V <br />h <br />0 <br />y <br />'urchase Order Number: "`�' " �` Q r' <br />m <br />} <br />O <br />Zuote Number: 0 C \ '�� <br />h <br />$, <br />o <br />a <br />w <br />¢ <br />a <br />Z <br />h <br />E <br />v <br />> <br />_ <br />F' <br />O <br />Cl. <br />U <br />oa <br />5ampler(s) <br />�un•GLS� SGV 4VG- � L <br />x <br />s <br />� <br />� <br />Sampling Fee: Pickup Fee: <br />o'er, <br />Compositor Setup Date: / / Time: —/— <br />--- <br />E <br />v� <br />0 <br />a <br />E <br />z <br />a <br />O <br />a <br />ern <br />c� <br />> <br />Lab Number: STKVt 3-17919 <br />a <br />0 <br />F <br />a� <br />007 <br />amp <br />Num <br />Location Description <br />Date <br />Sampled <br />Time <br />Sampled <br />S <br />$ <br />c <br />'� <br />= E <br />E- <br />a <br />O <br />v <br />G <br />DW <br />Sub -3 <br />temarks: <br />Relinquished Date: Time: <br />Rel' d ed Date: Time: <br />Relinquished Date: Time: <br />I -W Jim <br />Received By: ate: Time: <br />Received By: Date: Time: <br />`� <br />Received By: Date: Time: <br />j 2Z I �b <br />`q �� I'l 60 <br />Corporate Offices & Laboratory <br />853 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 <br />Office & Laboratory <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) 5254172 / 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 />