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CHAIN OF CUSTODY <br />®Special www.fgUnc.com <br />Laboratory Copy' (1 of 3) <br />s � <br />� 35730:02/06/2017 I'I:Sf ULSC1211'I'IUN - See ItcVerse side for l'unianter. Presenauvr and �Sampling utlormauon <br />Client: San Joaquin County EHD S t <br />Address: San Joaquin Co. Environmental Health Dep <br />Water Quality Division a <br />Atm: Rodney Estrada y <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 3 —° <br />Phone: (209)468-0331 Fax: <br />Relinquished <br />fit.. <br />Date: Time:fished <br />°t�t� <br />Date: Time: <br />�/,W,;7- /�0 <br />x <br />Date: Time: <br />Received By: <br />Date: Time: <br />Received By: <br />1"6 <br />'�,/4ate: / Ti <br />Received By: <br />Date: Time: <br />Aff CIS'4Cornorate <br />Contact Person: Rodney Estrada ` <br />1 <br />¢ <br />8 <br />& Laboratory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />Phone: (209) 942-0182 <br />Fax: (209)942-0423 <br />Office & Laboratory <br />563 E. Undo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone; (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />Project Name: <br />Purchase Order Number: <br />Quote Number: ST 20160309-01 1� <br />22 <br />�i. <br />c <br />[az7 <br />w <br />a <br />j, <br />E <br />o0o <br />a <br />G <br />0 <br />O <br />Sampler(s) <br />cn�J\ <br />Sampling Fee: Pickup Fee: <br />g <br />°' <br />v <br />' <br />o <br />a] <br />Compositor Setup Date: / / Time: / <br />a <br />E <br />o <br />o <br />N <br />z <br />o <br />O <br />'� 5 <br />= z <br />o N <br />v O <br />5z <br />a <br />e o <br />v z <br />k <br />= <br />u 0 <br />A <br />n <br />2 <br />E <br />[— <br />a <br />v <br />Lab Number: STK ZZ3O2'l 3-17919 <br />lamp <br />Date <br />Time <br />Num <br />Location Description <br />Sampled <br />Sampled <br />2 <br />E, <br />o <br />CE O <br />U _ <br />[, �"'„ <br />fir, —: <br />X <br />is <br />I <br />4 \ �\ <br />V�+�1� <br />1�s��1, <br />�Q o�4 <br />G <br />DW <br />1 <br />l.l.l <br />��`� <br />j L <br />j� <br />Remarks: <br />Relinquished <br />fit.. <br />Date: Time:fished <br />°t�t� <br />Date: Time: <br />�/,W,;7- /�0 <br />Relinquished <br />Date: Time: <br />Received By: <br />Date: Time: <br />Received By: <br />1"6 <br />'�,/4ate: / Ti <br />Received By: <br />Date: Time: <br />Aff CIS'4Cornorate <br />Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />Phone: (805) 392-2000 <br />Env Fax: (8n5152.5 4172 1 An F2x- (8051392-2063 <br />& Laboratory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />Phone: (209) 942-0182 <br />Fax: (209)942-0423 <br />Office & Laboratory <br />563 E. Undo <br />Chico, CA 95926 <br />Phone: (530) 343-5818 <br />Fax: (530) 343-3807 <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />Phone; (805) 783-2940 <br />Fax: (805) 783-2912 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />Phone: (559) 734-9473 <br />Fax: (559) 734-8435 <br />