Laserfiche WebLink
,t <br /> PQM.N SAN JOAQUIN COUNTY <br /> 2` ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,CA 95202 D <br /> ' Telephone:(209)468-3420 Fax:(209)464-0138 Web:www•sJgov.org/ehdCE Ez <br /> CHAIN OF CUSTODY RECORD <br /> Title � r � -S Unit <br /> 1. Sampler's Name <br /> 2• Remarks <br /> Date Time Item Location ID# Unit Required <br /> (50rI L Analysis Condition/Temperature <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> ., �I I ,30 <br /> OReactivi <br /> ❑TTLC ❑TCLP N <br /> ❑STLC,if necessary <br /> 096-Hr Fish Bioassay <br /> ❑Cam 17 Metals❑pH <br /> ❑lgnitability❑ <br /> Reactivit <br /> ❑TTLC ❑TCLP <br /> ❑STLC,if necessary <br /> C196-Hr Fish Bioassay <br /> ❑Cam 17 Metals❑pH <br /> ❑Ignitability <br /> ❑Reactivit <br /> ❑TTLC ❑TCLP <br /> ❑STLC,if necessary <br /> C396-Hr Fish Bioassay <br /> ❑Cam 17 Metals❑pH <br /> ❑Ignitability <br /> ❑Reactivity <br /> ❑TTLC ❑TCLP <br /> ❑STLC,if necessary <br /> 096-Hr Fish Bioassay <br /> ❑Cam 17 Metals❑pH <br /> ❑ignitability <br /> ❑Reactivi <br /> 4.Q Sample transported in iced cooler <br /> 3. X Evidence tape <br /> �' -e /01ZYlio/I g��204ryt <br /> 5. Relinquished by �° Title Date Time <br /> Name <br /> Received byTime <br /> Title Date <br /> `Name // <br /> a <br /> Remarks (condition/temperature) <br /> 6. Relinquis►led by Title Date Time <br /> Name <br /> Received byDate Time <br /> Name Title <br /> Remarks(condition/temperature) <br />