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Special CHAIN OF CUSTODY <br />P unvtv.fglfnc.com <br />Laboratory Copy (1 of 3)' <br />35730:02/0612017 <br />TESTbESCRII'I 10\ - Ser Revcr+c .i:le for Container. Preservative- ud Samplmt <br />in(vnuation <br />Client: San.lonquin County, EHD <br />Comorate Offices & Laboratory <br />853 Corporation Street <br />Office & Laboratory <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Undo <br />Office & Laboratory <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. EnNronmental 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) 7348435 <br />Water Quality Division <br />a <br />; <br />Attn: Rodney Estrada <br />3 <br />1868 East Hazelton Ave. <br />u <br />Stockton, CA 95205 <br />3 <br />a <br />Phone: (209)468-0331 Fax: <br />°4 <br />Contact Person: Rodney Estrada <br />y <br />a <br />,, l <br />Project Name: L31-1-0 vO , (ra l � �cpj�^� `� 1 <br />� <br />&nA <br />� <br />Purchase Order Number: L��� <br />U <br />Quote Number: ST 20160309-01 S <br />a <br />N <br />¢ <br />Z <br />� <br />`✓ <br />E <br />a. <br />o <br />O <br />N <br />o <br />0O <br />ua <br />Sampler(s) <br />Sampling Fee: Pickup Fee: <br />c <br />a <br />o <br />Compositor Setup Date: /_/ Time: I <br />EQ <br />`o <br />CA <br />z <br />-E <br />a <br />eh <br />°: z <br />c, <br />u 0 <br />cz <br />u <br />h <br />E <br />A F <br />Lab Number. STK 3-17919 <br />>amp <br />Date <br />Time <br />Num <br />Location Description <br />templed <br />Sampled <br />'' <br />H <br />o <br />a <br />t� <br />`° r' <br />a4O <br />° <br />U-- <br />0 <br />I.L. <br />w iL <br />,p <br />LA <br />G <br />DW <br />1 <br />111,1 <br />Remarks: <br />Relinquished <br />Date: Time: <br />Reli h Date: Time: <br />Relinquished Date: Time: <br />R ived y: Date: Time: <br />Rece ate: Time: <br />Received I Date: Time: <br />W6a� �� <br />.� 0 51t <br />Office & Laboratory <br />Comorate Offices & Laboratory <br />853 Corporation Street <br />Office & Laboratory <br />2500 Stagecoach Road <br />Office & Laboratory <br />563 E. Undo <br />Office & Laboratory <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) 7349473 <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) 7348435 <br />