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CHAIN OF CUSTODY <br /> ENVIRONMENTAL' www.fglinc.com com <br /> fgliAND ANALYSIS REQUEST DOCUMENT <br /> Ana"cal Chemists <br /> Client: San Joaouin Countv EHD Lab Nwnber: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Customer Number: 3017919 <br /> Address: Water Qualitv Division <br /> Attn: Michael Kith <br /> 1868 East Hazelton Ave. <br /> Phone: (209)468-3444 Fax: <br /> 7 V <br /> :- y s m <br /> Email Address: mkith(d)..sicehd.com s z <br /> Contact Person: Michael Kith 5 -t <br /> Project Name: 2 �- <br /> � 2430 N. Murray Rd. Linden � a � o <br /> Purchase Order Number: O y} s U <br /> ME r <br /> Quote Number: 00 m t <br /> Rush Analysis: EJ 5 Day❑4 Day FJ 3 Day❑ 2 Day❑ 24 hour 1p m 03 <br /> `m fl C <br /> CL <br /> Rush pre-approval by lab(initals): q a Z m tt�� m N cfli <br /> E O dJ o m g N <br /> Electronic Data Transfer: El No ❑State Client Other: U R _m <br /> z <br /> p s ry C + m <br /> Sampler(s): m © c'' m = r =ci <br /> m <br /> C C IO Y <br /> E p <br /> iil U _ m q v1 :3 " <br /> Sampling Fee: Pickup Fee: o <br /> o <br /> Compositor Setup Date. Time q m na <br /> $ E v 5 y F v <br /> Samp Location Description Date Time z ° (n Y v m <br /> NNuum— Sampled Sampled p <br /> 1 Wellhead <br /> [G [1—F— <br /> DW �����7�����F <br /> Remarks Relinquished Date: Time: Relinquished Date Time Relinquished Date. Time <br /> Replacement for STK1951713-1. r <br /> Received By: Date: Time: Received By: Date: Time: Received By: Date. Time <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory Office&Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lindo Avenue 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 San Luis Obispo,CA 93401 Visalia,CA 93291 <br /> TEL (805)l;92-2000 TEL:(209)942-0182 TEL:(530)343-5818 TEL:(805)783-2940 TEL:(559)734-9473 <br /> Env FAX:(805)525-4172/Ag FAX:(805)392-2063 FAX:(209)942-0423 FAX:(530)343-3807 FAX:(805)783-2912 FAX:(559)734-8435 <br /> CA FLAP Certification No.1573 CA ELAP Certification No.1563 CA ELAP Certification No.2670 CA FLAP Certification No.2775 CA ELAP Certification No.2810 <br />