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QWN OF CUSTODY <br /> Special f wundfdUncxom <br /> ° Laboratory Copy (1 of 3) <br /> ' 35730:02/06/2017 TES-T DE(WOPT10N - See Reverse side for Container,Preservative and Sampling info etA <br /> Client: San Joaquin County Ff D <br /> Address: San Joaquin Co. Enviro mental Health Dep D <br /> Water Quality Division,, 3 _ <br /> Atm:Rodney Estrada <br /> 1868 East Hazelton Ave. 3 <br /> Stockton,CA 95205 := <br /> a <br /> Phone: (209)468-0331 Fax: C7 w a <br /> Contact Person: Rodney Estrada D <br /> Project Name: 193 83 /��`� �bCi+r Cn <br /> Purchase Order Number: �U c U w 3 v� �• —' <br /> Quote Number: ST 20160309-01 L� <br /> Sampler(s) z <br /> o O •�N O w <br /> Sampling Fee: Pickup Fee: c = a c•i <br /> c w o C; a s <br /> Compositor Setup Date: I I Time: E <br /> a z p a °'z O E <br /> 3//-- cc <br /> 00 E c c c Z is. A EH <br /> Lab Number: STK p�33��3(p 3-17919 0 ��'• r. a _a �= <br /> 3amp Location Description Date Time 29 <br /> o <br /> Num Sampled Sampled F, a M M O V O N iw�: i3, w <br /> U,� <br /> 1 � �Z� .5v G DW 1 1,1,1 7.2 <br /> Remarks: Relinquished Date: Time: R shed ate: Time: Relinquished Date: Time- <br /> Jov -- / e i3 170-6 SIV5 1-7'qb <br /> i 1 ( Receive By: Date: Time: Received By: //a <br /> Date: Time: Received By: Date: Time: <br /> lZ <br /> f�a3 no <br /> Comorate Offices&Laboratory_ Office'84,Laboratory Office&Laboratory Office&Laborat000v Office&Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lindo 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93050 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)392-2083 Fax:(209)942-0423 Fax:(530)343-3807 Fax:(805)783-2912 Fax:(559)734-8435 <br /> r <br />