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<br />CHAIN OF CUSTODY <br />wwwiglinc.com <br />Field Copy (3 of 3) <br /> <br />Special <br /> <br />ElIVIRONMENTAL -_ AGRICULTURAL <br /> <br />Analytical Chemists <br /> <br />11 1 111 11 1 11 11 1111 1 1 35730.02/06/2017 TEST DESCRIPTION - See Reverse side for Container, Preservative and Sampling information <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 <br />Project Name: <br />Purchase Order Number: <br />Quote Number: ST 20160309-01 c Method of Sampling: Composite(C) Grab(G) Lab Number: STK 3-17919 Y., 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) Client: San Joaquin County EHD <br /><6 <br />Fi-r EA t (NIev, <br />A' 2 <br />1 EL--' <br />-g) rq <br />U <br />'RI o oc <br />o .0 <br />— <br />T.., o <br />74 c":-, <br />-cg cu tr, (..7 (NI <br />.5. . <br />Lu <br />P. <br />CI <br />0 <br />= <br />x E-c,. <br />72. 4 <br />g 1 1 <br />— co. tl., :.-i . <br />7, <br />. <br />. 22 <br />.g <br />.i.) <br />Sampler(s) <br />Sampling <br />Compositor <br />Fee: Pickup Fee: <br />Setup Date: / Time: / <br />Samp <br />Num L ocation Description Date <br />Sampled <br />Time <br />Sampled <br />1 / 1 1,1,1 <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 & 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