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LI`IVIROHMEIyTALFGMiRICULTURAL <br />CI MN OF CUSTODY <br />;Special `Uhm.,gUne.com <br />Laboratory Copy (1" f 3) <br />Corporate Offices & Laboratory ,/ <br />35730:02616/2017 <br />TEsfr DESCRIPTION See Reverse side for Container,i reservative and Samplinginformation <br />Office &Laboratory <br />'lienr: San Joaquin County EHD <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lando <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 />Adress: San Joaquin o. Environmental Health Dep <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />�� <br />' <br />Water QualitDivision <br />3 <br />a <br />Atm: Rodney,Es(rada <br />L <br />a <br />1868 East Hazelton Ave. <br />Stockton, CA 95205 <br />hone: (209)468-0331 Fax: <br />C7 <br />U1 <br />°G <br />'ontact Person: Rodney Estrada (Q.� <br />roject Name: ��� C �l�h <br />r; <br />'urchase Order Number: RCC, VIA@O <br />)uote Number: ST 20160309-01 <br />H <br />o <br />¢ <br />Z <br />`=3 <br />E <br />T <br />°' <br />A <br />ampler(s) <br />'C Y�l1t �L�510 <br />vii <br />O <br />a <br />iampling Fee: Pickup Fee: <br />C <br />° <br />v <br />� <br />o <br />:ompositor Setup Date: _/_/_ Time: _/_ <br />0 <br />rE <br />0 <br />c <br />o <br />o <br />z <br />a. <br />v <br />-S <br />p <br />F <br />u <br />w - <br />c <br />a� <br />U v <br />Z <br />U <br />o?"� <br />' o <br />c z <br />x <br />S <br />[= II <br />x <br />A <br />c <br />e <br />v <br />EE <br />a <br />.ab Number: STK 3-17919 <br />amp <br />Date <br />Time <br />Vum <br />Location Description <br />Sampled <br />P <br />Sampled <br />P <br />v <br />' <br />F <br />° <br />a <br />d <br />m <br />t� O <br />° <br />U— <br />`^ <br />0 c� <br />" r' <br />LL _: <br />" <br />W. <br />ia. <br />\ <br />G <br />DW <br />1 <br />1.1,1 <br />A0 <br />611-1, <br />(2� <br />remarks: <br />Relinquished Date: Time: <br />RelinquishCd D ter Time: <br />Relinquished Date: Time: <br />Iff W2z ILMD <br />N�a�I-a�- sur <br />Received By: Date: Time: <br />Recey d B ate: Time: <br />Received By: Date: Time: <br />z, <br />IR � <br />110, <br />w '0- NL/ - �Lj <br />Corporate Offices & Laboratory ,/ <br />Office & Laboratory <br />Office & Laboratory <br />Office &Laboratory <br />Office & Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Lando <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 />