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ENVIRONMENTAL —= AGRICULTURAL Analytical Chemists Special CHAIN OF CUSTODY P www.fgUnc.com Laborafory Copy (1 of 3) 11111111 `ill IIIhill Mill IIIIIIIIIVIIIVIIIIEIII ice & Laboratory 35730:02/06i2017 Office & Laboratory/ Office & Laboratory 853 Corporation Street TEST DESCRIPTION 563 E. Lindo See Reverse side for Container. Stockton, CA 95215 Preservative and Sampling information Phone: (805) 392-2000 Client: San Joaquin County EHD Phone: (530) 343-5818 Phone: (805) 783-2940 Phone: (559) 734-9473 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 Address: San Joaquin Co. Environmental Health Dep Water Quality Division 3 a Attn: Rodney Estrada 1868 East Hazelton Ave. Stockton, CA 95205 3 as a Phone: (209)468-0331 Fax: c? w 3 V) Contact Person: Rodney Estrada 2 _ Project Name: Purchase Order Number: w Quote Number: ST 20160309-01 w a z x a 00 Q Sampler(s) U �w ¢O Sampling Fee: Pickup Fee: 5 = v o p o Compositor Setup Date: /_/_ Time: / E K E Z p v E E� N = z o M . O cz ,��, Z Lab Number: STK 3-17919 0 -9p w a ,��, '� a, a = E a c E ?- a Samp Date Time Location Description Sam P led Sampled P �' � F ° co m ° w0 ° U� UN " a u,_: PO u. 1 VJ��i �F'i�sfl �1 l.�' •�� G DW Remarks: Relinquished Date: Time: RelinqT Date: elinquisbad Date: e• �J ) �Time: b Received By: Date: Time: Receiv By: Date: ived y. Date: Time: JTTiime: / Corporate Offices & Laboratory ice & Laboratory Office & Laboratory Office & Laboratory/ Office & Laboratory 853 Corporation Street 2500 Stagecoach Road 563 E. Lindo 3442 Empresa Drive, Suite'D 9415 W. Goshen Avenue Santa Paula, CA 93060 Stockton, CA 95215 Chico, CA 95926 San Luis Obispo, CA 93401 Visalia, CA 93291 Phone: (805) 392-2000 Phone: (209) 942-0182 Phone: (530) 343-5818 Phone: (805) 783-2940 Phone: (559) 734-9473 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