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<br />CHAIN OF CUSTODY <br />www.fglinc.com <br />CustOmer Copy (2 Of 3) <br /> <br />-BMR <br /> <br />Special <br /> <br />ENVIRONMENTAL AGRICULTURAL <br /> <br />Analytical Chemists <br /> <br />III 1111111111111111111111111111111 MI111111111111 35731.02/0612017 TEST DESCRIPTION - See Reverse side for Container, Preservativ r and Sampling information <br />Client: San Joaquin County EHD <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />Phone: (209)468-0331 Fax: <br />Contact Person: Rodney Estrada ( ,4 , , 0V._ 0 <br />Project Name: \\ . ( J t \'\ -I-- \ '- <br />Purchase Order Number: <br />Quote Number: ST 20160309-01 Method of Sampling: Composite(C) Grab(G) Type of Sample **SEE REVERSE SIDE** Potable(P) Non-Potable(NP) Ag Water(AgW) Bacti Type: Other(0) System(SYS) Source(SR) Waste(W) Bacti Reason: Routine(ROUT) Repeat(RPT) Replace(RPL) Other(0) Special(SPL) EPA 504.1-DBCP Only 40m1(VOA) Sampler(s) <br />Sampling <br />Compositor <br />, \'i <br />Fee: Pickup Fee: <br />Setup Date: / / Time: / <br />Lab Number: STK' 5,511 il 3-17919 <br />Num <br />Samp Date Location Description Sampled <br />Time <br />Sampled <br />0 Travel Blank G LBW 4 <br />1 \1,, G DW 4 <br />Remarks: <br />.kt:)AT- /-.)) <br />Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: lame: <br />Received By: Date: Time: <br />• <br />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. Undo 3442 Empresa Drive, Suite D 9415W. Goshen Avenue <br />Santa Paula, CA 93060 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) 392-2063 Fax: (209) 942-0423 Fax: (530) 343-3807 Fax: (805) 783-2912 Fax: (559) 734-8435