Laserfiche WebLink
( C'v� ® I I Please send results to: <br /> SAN JOA UIN COUNTY <br /> y Name: Lydia Baker <br /> ENVIRONMENTAL HEALTH DEPARTMENT Email: mnaidu@sicehd.com& Ibaker0skehd.com <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sigov.org/ehd •EHD staff to call for further instructions:Garrett Backus <br /> (209)468-2986,Michelle Henry(209)468-3453,Kasey Foley <br /> CHAIN OF CUSTODY RECORD (209)468-3451• <br /> I n /n <br /> Sample container description Required analysis <br /> TA number: / 5 b W G <br /> Y <br /> LydiaBaker W <br /> Sampler's name: o: v <br /> ."- <br /> Title: EHS 0 <br /> to :: a mLL d <br /> Unit: CUPA(111) v v a <br /> N <br /> Sample address °c I o } W v <br /> E z a E <br /> Brakemasters#163c a a $ y <br /> Facility name: m o <br /> c ° C eo m <br /> 1210 Tracy Blvd.,Tracy,CA 95376 ° Uu o > } U <br /> Facility address: m Z E <br /> E as v c 9 <br /> CL <br /> e! N <br /> Facility contact: Vince Blanchard o E re r E 3 A2L <br /> a <br /> Sample Sample source Date Time w a >d t C d _ <br /> number Sample location description sampled sampled 2 ' ~ W It: F- U) u v : w a ON <br /> C Solid 10-8-18 Na �P G ao: G N N <br /> Name Ti le t I� Date Time Remarks <br /> Relinquished by: � <br /> Received by <br /> LASER #T <br /> Relinquished by: VA. ti� '� �� tl` (.t-,� Z; Qrlllp Z <br /> d,Yr <br /> Received by: �a, 1� �®�, �t V�✓L� 1�},®�..( <br /> Relinquished by: <br /> Received by: <br /> Rev 07/31/15 <br /> CHAIN OF CUSTODY <br />