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MEMMAPPM <br />Wow <br />ENVIRONMENTAL = AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />Special " i www.fgUnc.com <br />Customer Cojy 12 of 3) <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />35730:02/06/2017 <br />TEST DESCRIPTION - See Reverse side for Container. Preservative 4d Sampling <br />information <br />Tient: San roaquin County EHD <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <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) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Address: San aquin Co. Environmental Health Dep <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />s <br />Wat Quality Division <br />.� <br />Attn: !Rodney Estrada <br />3 <br />a <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />c <br />?hone: (209)468-0331 Fax: <br />�ontact Person: Rodney Estrada <br />?roject Name: <br />vi <br />ti <br />7 <br />voi <br />?urchase Order Number: <br />Zuote Number: ST 20160309-01 <br />o <br />a <br />d <br />E <br />o <br />z <br />o <br />Sampler(s) <br />U <br />&n <br />O <br />a <br />O <br />V <br />0 <br />°' <br />�°o <br />x <br />w <br />Sampling Fee: Pickup Fee: <br />5 <br />a <br />;, <br />o <br />N <br />fl <br />Compositor Setup Date: _/_/ Time: _/_ <br />rE <br />b <br />S <br />w <br />z <br />O <br />a <br />0 <br />o z <br />[ z <br />a <br />w <br />= <br />A <br />a <br />H <br />Lab Number: STK 3-17919 <br />o <br />°' <br />n <br />H <br />04 O <br />Q E <br />°' 'k <br />v <br />° <br />o <br />Date <br />Time <br />.am <br />Num <br />Location Description <br />Sampled <br />Sampled <br />xa <br />o <br />U -- <br />0 c14 <br />°w <br />1 <br />G <br />DW <br />1 <br />1,L1 <br />temarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished Date: I imc: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: I-ime: <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <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) 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 />