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CHAIN OF CUSTODY <br /> FSpecial 't www.rglfnc.com <br /> Moratory Copy (1 of 3) <br />' 111111111 T11 11111111 111 35VO:02/06/2017 TEST DESCRIPTION - See Reverse side for Cotlinet,Preservative and Sampling information <br /> C lien[•. San Joaquin County EHD �s <br /> Address: San Joaquin Co. Environmental Health Dep <br /> Water Quality Division <br /> Attn:Rodney Estrada 3 <br /> f1868 East Hazelton Ave. <br /> Stockton,CA 95205 <br /> Phone: (209)468-0331 Fax: -- <br /> Contact Person: Rodney Estrada <br /> v 7 <br /> Project Name: 2;LO 2. Gi' C7 <br /> Purchase Order Number: �p., sf` U w 3 N —• <br /> > <br /> Quote Number: ST 20160309-01 y N <br /> o H <br /> 00 <br /> Sampler(s) ' u Oa O <br /> O <br /> * o p ca Q0 <br /> Sampling Fee: Pickup Fee: p; =' Q;N x <br /> Compositor Setup Date: / / Time: / E Q z O a Z Z z <br /> M <br /> E �. to U a C x <br /> Lab Number: STK 3-17919 0 w a v•. a s a <br /> Samp Date Time ;, v " o o •° •° <br /> Num Location Description Sampled Sampled v '� e o a� a <br /> P P P a o4 MO U- ON <br /> 1 2Z r D G DW 1 1,1,1 <br /> I <br /> i <br /> I <br /> Remarks: Relinquished Date: Time: RelDate: Time: Relinquished Date: Time: <br /> in sh <br /> C"5;0-f)r 9 1& <br /> f 5 1" a <br /> Received By: Date. Time: Received By: Date: Time: Received By: Date: Ti e: <br /> 5 Z5 �2 X855 5 2 0 <br /> Coroorate Offices&Laboratory Office&Laboratory Office&Labo_rato_rv_ Office&Laboratory Office&Laboratory <br /> 853 Corporation Street 3 2500 Stagecoach Road 563 E.Lindo 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 San Luis Obispo,CA 93401 Visalia,CA 93291 <br /> Phone:(805)392-2000 Phone:(209)942-0182 Phone:(530)343-5818 Phone:(805)783-2940 Phone:(559)734-9473 <br /> 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 <br />