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ENVIRONMENTAL — AGRICULTURAL <br />Analytical Chemists <br />CHAIN OF CUSTODY <br />Special www.fgUnc.com <br />Field Copy (3 of 3) <br />11111T11111 F111111 1-111 <br />3;731:08/02/2021 <br />TE4T DESCRIPTION See Reverse side for Container, <br />Preservative and Sa mpli47information <br />Client: San Joaquin County EHD <br />Address: San Joaquin Co.: Environmental Health Dep <br />Water Quality Division <br />a <br />Atm: Michael Kith <br />rx <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-3444 Fax: <br />C7 <br />W <br />a <br />Contact Person: Mikael Ki! ( <br />lr <br />¢ <br />S <br />x <br />Project Name: .�` 3 G'C�/C �� <br />Awa' <br />to <br />T <br />Purchase Order Number: Co Pon q/716 <br />� <br />•o <br />> <br />O <br />Quote Number: <br />E <br />�= <br />w <br />z <br />0 <br />U <br />A <br />Sampler(s) <br />�� <br />NX sf �•� i9 ��Y� <br />= <br />ex <br />a <br />p <br />N a <br />.� � <br />o <br />Sampling Fee: Pickup Fee: <br />E <br />a, <br />oro <br />Q <br />Compositor Setup Date: / / Time: / <br />--- -- <br />to <br />& <br />E <br />z <br />O <br />b <br />Lab Number: STK 3-17919 <br />0 <br />d <br />s <br />o <br />ii <br />a <br />p <br />w> <br />Samp <br />Location Description <br />Date <br />Time <br />Num <br />Sampled <br />Sampled <br />E' <br />a° <br />ri <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished Date: l ince: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: I ime: <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 />