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State of California - California Environmental Protection Agency <br />Northern California Region OFFICIAL SAMPLE RECEIPT <br />Sacramento Office <br />1001 1 Street <br />Sacramento, CA 95812-0806 <br />LCenlerive5826-3200 <br />700 Heinz Avenue <br />Berkeley, CA 94710-2721 <br />Clovis Office <br />1515 Tollhouse Road <br />Clovis, CA 93611-0522 <br />Department of Toxic Substances Control <br />Southern California Region <br />Chatsworth Office <br />9211 Oakdale Avenue <br />Chatsworth, CA 91311-6505 <br />Cypress Office <br />5796 Corporate Avenue <br />Cypress, CA 90630-4732 <br />San Diego Office <br />9174 Sky Park Court, Suite 150 <br />San Diego, CA 92123-4340 <br />Imperial County CUPA Office <br />627 Wake Ave <br />EI Centro, CA 92243 <br />Finn Name <br />Date <br />Stockton Propeller, Inc. <br />06/03/2021 <br />Address <br />city <br />Zip Code <br />2478 Wilcox Road <br />Stockton, CA <br />95215 <br />1'1 <br />LtaLL IlK U#4eA^,os whhe ,.mk+ <br />OC G VLe- <br />+5 N/1n er 1 is W.cMI si,.w s <br />0 <br />The items listed below were collected as official samples on this date as authorized by Section 66272. 1, California Code of <br />Regulations, Title 22. <br />Quantity <br />Unit Sim <br />Sample Deacripnoa <br />,D Number <br />32e <br />L o4lo- ,r�, Color <br />5P-ol <br />3 2.oz, <br />LtaLL IlK U#4eA^,os whhe ,.mk+ <br />- 02 <br />32o7. <br />UQuo - CA r ,n colo- <br />SQ -o3 <br />lI <br />32.oz- <br />LI&A-0 - t W 4 lofret►91"I In eolhe <br />SP -04A <br />LIawo - be,V btow r..o cojor <br />sp-o`i?b <br />3ZoZ <br />L4 n iM or <br />SP- O <br />160.2- <br />I-4 Qu to - ark- bt n %- or <br />SP- 0 S ES <br />no -1. <br />uawo <br />32o z <br />Seal — Lt &qEAk4,. fi tiNA&S <br />P- o <br />so1,a -1 c ��� e <br />s P-oe <br />Receipt acknowledged b <br />m By: <br />P'nt and Sim OT <br />Agmr <br />L7f�G_ j A op, Aeders0", <br />DTSC 1237 (04/12) <br />ON <br />