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r <br />NVIROrNMENTAL — AGRICULTURAL <br />Analytical Chemists <br />Special <br />CHAIN OF CUSTODY . <br />www.fgUnc.com <br />Field Copy (3 of 3) <br />1liI1IIIIIIIIIIIIII1I'ItIII�II�III I'I�III'III°niIIIIIII <br />35731:08/02!2021 <br />TE ,I' DESCRIPTION See Reverse side for Container. Preservative and Sampling information <br />Client: San Joaquin County EHD <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Linda <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 />Address: San Joaquin Co.nvironmental Health Dep <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 />Water Quality Dlyiston <br />3 <br />Attn: Michael Kip <br />„ <br />x <br />1 <br />1868 East Hazelfbn Ave. <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-3444 Fax: <br />x <br />Person: Michael Kith <br />� <br />Q <br />�„ <br />¢Contact <br />E <br />Project Name: <br />a <br />b <br />� <br />a <br />o <br />Purchase Order Number: <br />U <br />w <br />3 <br />¢ <br />x <br />o <br />Quote Number. <br />o <br />o <br />w <br />rx <br />vw <br />z <br />E <br />> <br />O <br />a <br />U <br />Q <br />Sampler(s) <br />V <br />�. <br />v <br />^ <br />a <br />O <br />0 <br />Sampling Fee: Pickup Fee: <br />; <br />< <br />Compositor Setup Date: _/ / Time: <br />E <br />o� <br />Lab Number: STK 3-17919 <br />c <br />y <br />T <br />w <br />L <br />a <br />, y <br />m j <br />007 <br />c <br />Samp <br />Location Description <br />Date <br />Time <br />Sampled <br />Num <br />Sampled <br />� <br />F- <br />do <br />m <br />w p <br />1 <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Relinquished Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <br />Received By: Date: Time: <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. Linda <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 />