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State of Cafdomia— California Environmental Protection Agency <br />Northern California Region OFFICIAL SAMPLE RECEIPT <br />Sacramento Office <br />1001 1 Street <br />Sac 95812-0806 <br />Cal Center Office <br />8800 Cal Center Drive <br />Sacramento, CA 95826-3200 <br />e ey tee <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 />Stockton Propeller, Inc. <br />Date <br />06/03/2021 <br />ressQty <br />2478 Wilcox Road <br />Stockton, CA <br />zipcode <br />95215 <br />SAA 15i -N �oe9 <br />E'fIS Wka i.. e.l; 1 ISL. Wlt♦•nl Sl <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 Size <br />Sample Deuripfian <br />ID Number <br />f <br />Utz, <br />Lt <br />3 <br />L'&4*, - View- 4•tvce- <br />SP - 10A <br />' <br />�`[7 <br />4Qa4aQ U i ��a7f t� •^ COSor <br />SC— ��}i <br />Re\ceipt acknowledged bye l(' — <br />dSigo Amaaeiz<d Agem <br />VTSC- 2.✓So't — <br />DTSC 1237 (04/12) Z. C) F Z <br />