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EIYVIROi�h1ENTAL� 'AG RICL)L URAL. <br />Awilvtical Chcnusts <br />Special Cin OF CUSTODY <br />P www.fgUnc.com <br />Laboratory Copy (1 of 3) <br />35730:02/06/2017 <br />TEST DESCRIPTION See Reverse side fir Container. Preservative and Sampling <br />information <br />'lien[•. San Joaquin County EHD <br />E <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Office &Laboratory <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Lindo <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />{ <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />address: San Joaquin Co. Environmental Health Dep <br />Phone: (805) 783-2940 <br />Phone: (559) 7349473 <br />Env Fax: (805) 5254172 /Aa Fax: (805)392-2063 <br />Fax: (2091942-0423 <br />Fax: (530)343-3A07 <br />Fay (Rnfiil 7R3 -9g19 <br />Fay (554) 714-Rd35 <br />Water Quality Division <br />a <br />Atte: Rodney Estrada <br />1868 East Hazelton Ave. <br />H <br />Stockton, CA 95205 <br />3 <br />0 <br />'hone: (209)468-0331 Fax: <br />x <br />x <br />'ontact Person: Rodney Estrada <br />-( 1 <br />'roject Name: 2� "\ 0 1 \�ja <br />urchase Order Number: <br />tuote Number: ST 20160309-01 <br />E <br />w <br />z <br />T <br />N <br />'$ <br />N <br />;ampler(s) <br />� offf <br />nS <br />°�� <br />is <br />v aM <br />a <br />x <br />>ampling Fee: Pickup Fee: <br />c <br />o <br />:ompositor Setup Date: _/_/_ Time: _/_ <br />4. <br />y <br />o <br />o <br />O <br />z <br />o <br />O <br />'U <br />o g <br />2 <br />N <br />fd <br />o z <br />oLocation <br />z <br />o <br />v <br />v <br />v <br />ab Number: STK 3-17919 <br />amp <br />Date <br />Time <br />Vum <br />Description <br />SampledSampled <br />A <br />aO <br />U � <br />t7 N <br />o <br />is =: <br />V. <br />G <br />DW <br />1 <br />1,1.1 <br />'emarks: <br />Relinquished Date: Time: <br />Relinqu' Ise te: Time: <br />Relinquished Date: Time: <br />27i 11� <br />ijD <br />LS ����/ZZ lG 3 <br />Received By: Date: Time: <br />ecei dBi Time: <br />Received By: Date: Time: <br />ga I <br />1��U <br />Coif 1 .L <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Office &Laboratory <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Lindo <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />Phone: (805) 392-2000 <br />Phone: (209) 942-0182 <br />Phone: (530) 343-5818 <br />Phone: (805) 783-2940 <br />Phone: (559) 7349473 <br />Env Fax: (805) 5254172 /Aa Fax: (805)392-2063 <br />Fax: (2091942-0423 <br />Fax: (530)343-3A07 <br />Fay (Rnfiil 7R3 -9g19 <br />Fay (554) 714-Rd35 <br />