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CHAIN OF CUSTODY <br /> ENVIRONMENTALAND ANALYSIS REQUEST DOCUMENT <br /> Lab Num : TEST DESCRIPTION AND ANALYSES REQUESTED <br /> �3�/ z <br /> etiene Llve Oak GwEnvironrttental <br /> Customer Number. 3016608 <br /> Address: 407 W.Oak St. <br /> Lodi,CA 95240 <br /> Phone: (209)369-0375 Fwr. (209)369-0377 gg <br /> Email Address: abby@logelodi.corrl <br /> confect persw: Abby Racco E <br /> pro)=Nvne.. Conlin Property.22201 E.Frazier 8 22260 E. <br /> Harney,Linden g o <br /> P <br /> (?nate <br /> N Order Num rn gg <br /> (?nate Number: <br /> 6 3 i <br /> Sempler(s): Jessen Welch <br /> . m <br /> S Fee <br /> PickupFat, <br /> Composite Setup Dak: Time: <br /> aA G <br /> Samp Location Description Data Tune g§ 8 F $ 2 �, <br /> Num Sampled SamPlad a <br /> X <br /> 0 Travel Blank ��'I I G G <br /> Well I G 3 PIG P DW RC O 4 X X <br /> Remarks I;nquiahed muTime <br /> fished Dote: Time h Date: Time: <br /> / 170 <br /> Tune. ed te: Time: <br /> gy. pore Tune: Rmeived By: are. � ,� Ir <br /> ���/� /7° <br /> eField OIRe <br /> � <br /> I:orPerata Oaloes a Laboratory a l Laboratory 583 Eoft..6&L hebovenuentory .� vlaalia,Caldomla <br /> a63 Corporation Street 2500 Stagecoach Road CNco,CA 95928 TEL 5591734-9473 <br /> Santa Paula,CA 93060 Stockton.CP.95215 TEL:530/343-5818 Mobile:e_%R37-2399 <br /> TEL:908/392-2000 TEL:2091942-0182 FAX:530!343-3807 FAX 5598349435 <br /> FAX:8061526-4172 FAX 209842-0423 <br /> CA ELAP Cerl rcatlon No. 1563 CA ELAP Cartdigbon Na.2670 <br /> CA/\NELAP Certiflndon No.01NOG4 1 <br /> J J r� <br />