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"!NVIRONMENTAL — AGRICULTURAL <br />Analytical Chemists <br />CHMN OF CUSTODY <br />Special www.fgUnc.com <br />' Laboratory Copy (1 of 3) <br />Corporate Offices & Laboratory <br />3_;731:08/02;2021 <br />l l:SI DLS('Rll'l l0N Sce Re\ersc Nide too (''.)namer. Preser\au�e and Sampling inlunnatiun <br />Client: San Joaquin Count3 EHD <br />Office & Laboratory <br />853 Corporation StreetJ , <br />1 <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <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 />Address: San Joaquin Co. Environmental Health Dep <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />Water Quality Division <br />a <br />Attn: Michael Kith <br />3 <br />1868 East Hazelton Ave. <br />b <br />Stockton, CA 95205 <br />3 <br />o. <br />Phone: (209)468-3444 Fax: <br />w <br />3 <br />� <br />v <br />x <br />Contact Person: Michael Kith <br />Q <br />11 ll <br />Project Name: t t r?(. f C"'r &jam �L0" <br />C7 <br />o <br />Purchase Order Number: <br />y <br />Quote Number: <br />ou <br />a <br />E <br />w <br />z <br />E <br />Sampler(s) I_ <br />Sampling Fee: Pickup Fee: <br />5 <br />Compositor Setup Date: / / Time: <br />E <br />0 <br />fl <br />E <br />z <br />a <br />O <br />a <br />x <br />O <br />lu <br />w <br />J .-•. <br />Lab Number: STK J 3-17919 <br />0 <br />o <br />v <br />E~ <br />a� <br />�L) <br />Samp <br />Location Description <br />Date <br />Time <br />sS <br />n <br />D <br />Num <br />SampI d <br />Sampled <br />H <br />a° <br />m <br />m O <br />G <br />DW <br />Sub -3 <br />Remarks: <br />Relin <br />is d Tithe: <br />: Time: <br />Relinqu' a D�1)- <br />Relinquished Date: Time: <br />70 <br />[ate:4 t).Lj <br />I�UL) <br />e 'v D te: Time: <br />Receiv By- e: Tim <br />Received By: Date: Time: <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />853 Corporation StreetJ , <br />1 <br />2500 Stagecoach Road <br />563 E. Lindo <br />3442 Empresa Drive, Suite D <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) 734-9473 <br />Env Fax: (805) 525-4172 / Ag Fax: (805) 392-2063 <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />