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CHAIN OF CUSTODY <br /> ENVIRONMENTAL AND ANALYSIS REQUEST DOCUMENT <br /> 4 ab jaluu b�� TEST DESCRIPTION AND ANALYSES REQUESTED <br /> ,Client: Live Oak GeoEnvironmental <br /> Customer Number: 3016608 <br /> Address: 407 W.Oak St. <br /> Lodi, CA 96240 <br /> Phone,: (209)369-0375 Fax: i ! <br /> email Address: abby@logelodi.com <br /> Contact Person: Abby Racco m 0 8 1 <br /> t <br /> Project Name: Singh/Kaur, 3566 W. Eleventh St.,Tracy �I i <br /> Purchase Order Number. < g = ? <br /> Quote Number. E o ` <br /> a _ <br /> Sampler(s): <br /> J N <br /> Sampling Fee: Pickup Fee: to F x <br /> E ID <br /> Compositor Setup Date: Time: in° z y <br /> Samp Location Description Date Time o o <br /> Num ( I Sampled I Sampled z t— a in N rn a <br /> 0 Travel Blank G 2 G X , <br /> 1 Domestic Well //�Zi c''e Qn Gy 3 P/G P DW SRC O X X <br /> l - <br /> . <br /> Remarks RelingbisW D tc: Tike: Relinquished Date:/p Time: Relinquished Date: Time <br /> 7 Day RUSH <br /> Received By: Date: Time: Received By: bate: Time: Received By: Date: Time: <br /> iv <br /> Corporate Offices&Laboratory Offlee&Laboratory Office&Laboratory Field Office <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lando Avenue Visalia,California <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chioo,CA 95926 TEL:559f734-9473 <br /> TEL:8051392-2000 TEL:209/942.0182 TEL:530/343-5818 Mobile:5591137-2399 <br /> FAX:805/525172 FAX:209/942.0423 FAX:530/343-3807 FAX:5591734.8435 <br /> CA NEL.AP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />