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FGL Special CHAIN OF CUSTODY <br /> ENVIRONMENTALp www.fgUnc.com <br /> AnalYtical Chemistst <br /> Sz Laborato . Copy (1 of 3) <br /> 35731:081 120211 TEST DESCRIPTION - See Reverse side for Container.Prese ive and Sampling information <br /> Client: San Joaquin County EHD r <br /> Addre San Joaquin Co.Environmental Health Dep <br /> Water Quality Division <br /> Arm:Michael Kith 3 �' <br /> a 1868 East Hazelton Ave. <br /> c <br /> WStockton,CA 95205 3 <br /> u <br /> Phone: '(209)468-3444 Fax: a' <br /> Contact Person: Michael Kith `, 9 <br /> Project Name: <br /> Purchase Order Number: A v 3 H c <br /> Or `5ti1 � �^ r x o <br /> Quote Number: — G U <br /> $ E <br /> Sampler(s) c N y r q <br /> Sampling Fee: Pickup Fee: c ? 5 H g <br /> Compositor Setup Date:_/_/_ Time:_/_ o, Z O a a cv <br /> Lab Number: STK 71 3-17919 <br /> o = K C7 <br /> amp Date Time -S <br /> Num Location Description Sampled Samptlled 0 a m m O <br /> I VJL.i, l &Lb 1 5�1L ���.I,O G DW Sub-3 <br /> Remarks: Rin shed Date: Time: Relinge�� Date: Time: Relinquished Date. Time: <br /> lu L`� wig- 5 ZZ ►-tpD <br /> Received By:,t _ a Tim : Receive By: ate: Tim Received By: Date: Time: <br /> 17� <br /> Corporate Offices&Laboratorynnnnn� [y Office 8 Laboratory Office&Laboratory Office&Laboratory Office&Laboratory <br /> 853 Corporation Street "1 7v 2500 Stagecoach Road 563 E.Lindo 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93060 vl(V Stockton,CA 95215 Chico,CA 95926 San Luis Obispo,CA 93401 Visalia,CA 93291 <br /> Phone:(805)392-2000 Phone:(209)942-0182 Phone:(530)343-5818 Phone:(805)783-2940 Phone:(559)734-9473 <br /> Env Fax:(805)525-4172/Ag Fax:(805)392-2063 Fax:(209)942-0423 Fax:(530)343-3807 Fax:(805)783-2912 Fax:(559)734-8435 <br />