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ENVIRONMENTAL <br /> AND ANALYSISREQUEST DOCUMEAT <br /> Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> 'Eat Awa <br /> Client Live Oak GeoEnvironmental <br /> Customer Number: 3016608 <br /> Addrou: 407 W.Oak St. <br /> Lodi,CA 95240 _ <br /> Phone: (209)369-0375 Far'. (209)369-0377 <br /> Email Address'. abby(glogelodi.com d <br /> cmwaPerson: Abby Raec0 3 <br /> projad Name Zuckerman Mandeville, 111 N.Zuckerman Rd., �" v <br /> Stockton $ re <br /> Purchase Order Number. a C ygEP €g op `r' <br /> Quote Number: S_ S <br /> Sampler(s). Jessen Welch c3 gg $, Yu „ <br /> 7� <br /> � 49- 40 <br /> � _ j <br /> Sampling Fee: Pickup Fee: T �' f 5. 0 z <br /> Compositor Setup Dek'. Time: b ig <br /> Samp Location Description Dune Time b `" a C <br /> Num Sampled Sampled r S a, Sid m rn` C <br /> 0 Travel Blank G 2 X _ <br /> 1 Domestic well at acki shed -11-P O / G 3 PIG P DW SRC O 4 X X <br /> 2 Domestic well at labor camp •/ 47 /r G 3 PIG P DW SRC O 4 X X <br /> 3 Domestic well at shop -/�'�s�- / G 3 PIG P OW SRC O 4 X X <br /> Remarks KR� <br /> h a Time had a Tim, Relmritnshed Date Time. <br /> � X40 <br /> By: Date'. Time. Ra ived Bye Time: Received By. Dal Time. <br /> 74 L <br /> Corporate 011110es 6 Lawrawry e 6 4bwawry office 6 Laborefwy F aid Mee <br /> 553 Corporatlon Street stage In Road 583 E.LIMO Avenue Vlaalia,Callornla <br /> Santa Paula,CA 93060 1.1.1,CA 95215 Chlco,CA 95926 TEL 559034-6473 <br /> TEL 805/392-2000 TEL 209/9420152 TEL 53W435818 Mobile'.559037-23% <br /> FAX 8051525-4172 FAX 2099420423 FAX 530f3433807 FAX 559034-5435 <br /> CA NELAP Cenmcatlon No.oilloCA CA ELAP Cenificanon No 1563 CA ELAP CBlfification No.2070 <br />