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UHAIN OF UUSTODY <br />Special ww , gUncxom <br />Laboratory Copy (1 of 3) { <br />• <br />35730:02/06/2017 <br />TEST D . CHIPTION - See Reverse side for Container. Preservative and Sampling <br />inf ' at6 <br />'lien[-. San Joaquin County PD <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 />tddress: San Joaquin Co. Envinmental Health Dep <br />Fax: (209) 942-0423 <br />Fax: (530) 343-3807 <br />Fax: (805) 783-2912 <br />Fax: (559) 734-8435 <br />�t <br />Water Quality Divisio <br />Attn: Rodney Estrada <br />a <br />1868 East Hazelton Ave. <br />A <br />Stockton. CA 95205 <br />3 <br />a <br />'hone: (209)468-0331 Fax: <br />C7 <br />w <br />rx <br />'ontact Person: Rodney Estrada12 <br />Q <br />/ A <br />Name: 7_4;7c)�ellWe - L t(-de� <br />vwi <br />A <br />F-4'roject <br />1 \ <br />'urchase <br />Order Number: <br />U <br />� <br />m <br />w <br />Note Number: ST 20160309-01 <br />o <br />W <br />PG <br />¢ <br />z <br />v <br />E <br />F <br />O <br />p <br />o <br />�_ <br />A <br />ampler(s) <br />U <br />vWi <br />>, <br />ampling Fee: Pickup Fee:n. <br />0 <br />0 <br />43 <br />° <br />ao <br />$ <br />w <br />'ompositor Setup Date: / / Time: / <br />— -- <br />E <br />0 <br />o <br />a <br />E <br />0 <br />c <br />zo <br />u <br />0 <br />p <br />FT <br />O G <br />x " <br />cy <br />aO <br />v <br />t: <br />" <br />o <br />u as <br />o�w <br />= E <br />_ <br />1° O <br />cx <br />E <br />jyi <br />(~ II <br />x <br />A E <br />D (- <br />x x <br />a a <br />v v_ <br />.ab Number: STK 3-17919 <br />imp <br />Date <br />Time- <br />hum <br />Location Description <br />Sam led <br />P <br />Sam led <br />P <br />" <br />[- <br />o <br />a <br />U <br />as <br />A '5 <br />oa O <br />0 0 <br />u <br />„ o <br />C� N <br />= c1 <br />is -: <br />w R <br />is is <br />1 <br />(/t% % <br />ZZ <br />G <br />DW <br />l <br />1,1,1 <br />/Z ,c <br />Relinquished Date: Time: <br />Relinqu' ed D , Time: Relinquished <br />Date: %� Tie:51 <br />t� <br />L <br />v <br />Received B : Dau: Time: <br />Receiv By• D u: Time: <br />� <br />Red By: Date: Time: <br />c t <br />1 <br />i� <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Offlce & Laboratory <br />Office & Laboratory U <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 />