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Special <br />CHAIN OF CUSTODY <br />www.fglinc.com <br />Customer Copy (2 of 3) <br />111111111111111111111111111111111111111111111111111111111111 35731.02/06/2017 TEST DESCRIPTION - See Reverse side for Container, Preservative and Sampling information <br />., <br />Client: <br />Address: <br />Phone: <br />Contact <br />Project <br />Purchase <br />Quote <br />San Joaquin County EHD . <br />San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelion Ave. <br />Stockton, CA 95205 <br />(209)468-0331 Fax:c4) <br />Person: Rodney &strada . - verya 1--_-5c(mior-i .. , ) <br />Name: 2:2-°""*J'i f-' ' 1 <br />Order Number: <br />Number: ST 20160309-01 <br />& <br />fa <br />X <br />o u <br />ijo = <br />71 g c.) <br />"6' <br />7:3 <br />t <br />E 41 <br />t4 <br />(ID <br />in <br />. 2 • <br />1 <br />(,) <br />„ 12, E t -, <br />a 1-.- <br />r.n g <br />. t <br />Z ,...- _SI <br />o a. <br />0 <br />Z <br />ii.,' <br />t <br />R. , <br />'S <br />--- G.) <br />< 0 <br />3 <br />c4 <br />84) <br />cn <br />> '' <br />V,' >--. w) <br />a — ,-. <br />cl-. <br />a <br />t <br />.4 5 8 <br />ai <br />7-,-1, <br />k ed — <br />g <br />,7,., C) <br />E <br />r•.- <br />ii <br />0 ix <br />E 55 5 .- - <br />H " <br />al <br />g2 0 <br />00. <br />_ <br />at, <br />ral 9 <br />4 0 <br />Et3 .i. <br />Sampler(s) <br />Sampling <br />Compositor <br />FraliciSco 12 t4 13 <br />Fee: Pickup Fee: <br />Setup Date: / / Time: I <br />Lab Number: STK 3-17919 <br />Samp <br />Num Location Description Date <br />Sampled <br />Time <br />Sampled <br />0 Travel Blank G LBW 4 <br />1 G DW 4 <br />- <br />. _ <br />Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br />Received By: Date: Time: <br />(--' <br />Received By: Date: Time: Received By: Date: Time: <br />Corporate Offices Offices & Laboratory Office & Laboratory Office & Laboratory Office & Labora ory 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 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