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ENVIRONMENTAL CHAIN OF CUSTODY <br /> _ e AND ANALYSIS REQUEST DOCUMENT <br /> Lab N ber TEST DESCRIPTION AND ANALYSES REQUESTED <br /> ;Client: Live Oak GeoEnvironmental <br /> j-ustomer Number: 3016608 <br /> 9 <br /> g <br /> 'Address: 407 W.Oak St. { <br /> Lodi,CA 96240 E a <br /> Phone: (209)369-0375 <br /> Fax: � � <br /> r i <br /> Email Address: abby@logelodi.com <br /> Contact Person: AbbyRaceo <br /> o ; — <br /> Project Name: Block 21 Winery,21600 N. Davis Rd. <br /> Pumhase Order Number: Lodi, CA <br /> Quote Number. 'R 0 <br /> Sampler(s): <br /> o <br /> r � g 1 r f <br /> Sampling Fee: _ Pickup Fee: s y <br /> r <br /> Compositor Setup Hate. Time: <br /> CO2 } <br /> Sam Location Description Date Time t my <br /> p <br /> Num Sampled 1 Sampled z ►— <br /> 0 Travel Blank 2 G <br /> X <br /> 1 BeRmn tC Well Iry 1%0.w g ` <br /> =P/G P ADW <br /> SRC. O : XX : <br /> { j F <br /> .. _ ... ti ._.. F.... ._...._-�r,. .. <br /> . _. . __.. _. SH .._. <br /> _..._..a ......,. .. <br /> is <br /> a a <br /> , <br /> -- J- i j 0 - 4+. - <br /> i <br /> Remarks Rcli fished Date: Time: hed Q te: Time: elinqui ed Date: Time: <br /> 1 <br /> _11.1 to:zo , /9l8 /7aa <br /> V-S Rcc Time: Received By: ate: Time: i By: D c: Timc: <br /> Y/01' boa-U 9118 /7z 9 <br /> Corporate OHicea&Laboratory Office&Laboratory Office&Laboratory Fled ce <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Undo Avenue Visalia,California <br /> Santa Paula,CA 93060 Stockton,CA 9521 S Chico,CA 95926 TEL:559!734-9473 <br /> TEL:805/392-2000 TEL:2091942-0182 TEL:530/343-5818 Mobile:5591737-2399 <br /> FAX:805/525-4172 FAX:209/942.0423 FAX:5301343-3807 FAX:5591734-8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />