Laserfiche WebLink
<br />CHAIN OF CUSTODY <br />www.fglinc.corn <br />Field Copy (3 of 3) <br /> <br />Special <br /> <br />usiViRoNmENTAL AGRICULTURAL <br /> <br />Analytical Chemists <br /> <br />H I III I I 1111111 11111 I I II 35731:02/06/2017 TEST DESCRIPTION - See ReverseSide for Container, Preservative and Sampling information <br />Client: <br />Address: <br />Phone: <br />Contact <br />Project <br />Purchase <br />Quote <br />San Joaquin Co. Environmental Health Dep <br />Water Quality Division <br />Attn: Rodney Estrada <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />(209)468-0331 Fax: <br /> <br />Person: Rodney Estrada <br />Name: <br />Order Number: <br /> <br />Number: ST 20160309-01 0 Method of Sampling: Composite(C) Grab(G) San Joaquin County EHD r tz 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) "g 0 <br />a. u go <br />9 — <br />FA > <br />< "R <br />Sampler(s) <br />Sampling <br />Compositor <br />Fee: Pickup Fee: <br />Setup Date: / Time: / <br />Lab Number: STK 3-17919 <br />Num <br />Samp Date <br />Sampled Location Description Time <br />Sampled <br />0 Travel Blank 4 <br />1 G DW 4 <br />Remarks: Relinquished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <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 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