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HE <br />ENVIRONMENTAL = AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />Special ; www.fgUnc.com <br />CLIS+m r Copy (2 of' 3) <br />Corporate Offices & Laboratory Office & Laboratory <br />853 Corporation Street 2500 Stagecoach Road <br />Santa Paula, CA 93060 Stockton, CA 95215 <br />Phone: (805) 392-2000 Phone: (209) 942-0182 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />35731:08/0 !2081 <br />LEST DESCRIPTION See Reverse side for Container. 1' . >et°vative and Sampling inturmation <br />'11s nt: San Joaquin County EHD <br />fi; <br />,dOress: San Joaquin Co. Environmental Health Dep <br />< <br />t <br />Water Quality Division <br />a <br />Attn: Michael Kith <br />5 <br />L <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />'hone: (209)468-3444 Fax:Cn <br />� <br />w <br />3 <br />a <br />.ontact Person: Michael Kith <br />¢ <br />7 <br />/ n , <br />'roject Name: L lv'�J4� N ! <br />O <br />(nT <br />!x <br />Order Number: <br />U <br />W <br />3 <br />¢a <br />� <br />° <br />C:'urchase <br />O <br />)uote Number: <br />Y <br />0 <br />o <br />o <br />a <br />W <br />(nz <br />a <br />`�'' <br />a�Ei <br />>1 <br />F <br />o <br />U <br />W <br />A <br />;ampler(s) <br />U <br />* <br />W <br />.2 <br />sampling Fee: Pickup Fee: <br />E <br />o <br />O <br />; <br />•a rn <br />o <br />,n <br />;ompositor Setup Date: ! / Time: <br />c <br />z <br />0 <br />j <br />,ab Number: STK 3-17919 <br />0 <br />0 <br />a <br />=' <br />H <br />06 <br />�" <br />'0 <br />p C7 <br />Amp <br />Location Description <br />Date <br />Sampled <br />Time <br />Sampled <br />Q <br />o <br />5 <br />O <br />:3c <br />Jum <br />t., <br />p., <br />m <br />w <br />v6 v <br />1 <br />G <br />DW <br />Sub -3 <br />.emarks: <br />Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: 1 ime: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Corporate Offices & Laboratory Office & Laboratory <br />853 Corporation Street 2500 Stagecoach Road <br />Santa Paula, CA 93060 Stockton, CA 95215 <br />Phone: (805) 392-2000 Phone: (209) 942-0182 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 Fax: (209) 942-0423 <br />Office & Laboratory <br />563 E. Lindo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone: (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />