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Ck <br />ENVIRONMENTAL AGRICULTURAL <br />Analytical Chemists <br />Special CHAIN OF CUSTODY <br />P www.fgUnc.com <br />Laboratory Copy (1 of 3) <br />�lIIIIIIJI�Ei[III IIIIIIlilhilIIIIEIlilIEill <br />Office & Laboratory <br />3 '30:02100,2017 <br />Office & Laborat <br />Office & Laboratory <br />853 Corporation Street <br />I -LSI DLSCILLPI <br />l0y <br />SCC RC%0I,L Mtic i,n C,uu,unCi. <br />Santa Paula, CA 93060 <br />Phone: (805) 392-2000 <br />Prcxnau�C <br />,in.l S�mplutg <br />utluwauun <br />Visalia, CA 93291 <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 />Client: San Joaquin County EHD, <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />3 <br />j <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />V <br />Stockton, CA 95205 <br />=' <br />a <br />Phone: (209)468-0331 Fax: <br />ax <br />CIO <br />Contact Person: R-@��� 0MA5� <br />d <br />i <br />T <br />Project Name: AA' CIAX—TI l C k- <br />w <br />lz <br />x <br />Purchase Order Number: <br />U <br />w <br />T <br />w <br />Quote Number: ST 20160309-01 <br />N <br />E <br />a <br />w <br />QV <br />`" <br />a <br />Q <br />00 <br />Q <br />Sampler(s) j <br />r ci 1a� lJl�( r%�� <br />p <br />Sampling Fee: Pickup Fee: <br />6b <br />5 <br />o <br />O <br />v <br />��_ <br />¢O <br />a <br />e <br />W <br />Compositor Setup Date: / / Time: <br />E <br />a <br />z <br />p <br />a y <br />NM <br />= ° <br />= <br />a� <br />z <br />E <br />_/ <br />v <br />0 <br />ii <br />.. 0 <br />n <br />oZ <br />Cz <br />irz <br />Lab Number: STK 3 3-17919 <br />5amp <br />Location Description <br />Date <br />Time <br />" <br />; <br />' <br />c <br />d r <br />= o <br />°_' <br />�' n <br />Num <br />Sam led <br />P <br />Sampled <br />P <br />i <br />t. <br />a <br />w <br />w O <br />N <br />U --0 <br />^ <br />c <br />r3 _: <br />is, w <br />11 00 <br />L, <br />G <br />DW <br />1 <br />1,1. I <br />G 5 <br />�� 1, <br />Remarks: <br />Reli quis ed Date: Time:to <br />ished D e: Time: <br />Relinquished Date: Time: <br />Y1G2,z,17 <br />Rel;' By: Date:Time: <br />Time: <br />Received By: 1p <br />Received By: Date: Time: <br />�j <br />n27.,,xM <br />�aJte: <br />QJ <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laborat <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Ive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Phone: (805) 392-2000 <br />Stockton, CA 95215 <br />Phone: (209) 942-0182 <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Visalia, CA 93291 <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 />