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CHAIN OF CUSTODY <br /> R.- <br /> 2741 <br /> ENVIRONMENTAL AND ANALYSIS REQUEST DOCUMENT <br /> iLab N0urr�b�r: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Client: Live Oak GeoEnvironmental I t <br /> Customer Number: <br /> 3016605 t I + 1 <br /> Address: 407 W.Oak St. ' <br /> Lodi CA 96240 <br /> Phone: (209)369-0375 Fax: <br /> E•maitAddress: abby@logelodi.com s i <br /> Contact Person: Abby Racco S~ o ! € <br /> Project Name:Patee,5420 E.Acampo Rd., Acampo, CA >l <br /> Purchase Order Number. <br /> Quote Number. a $ 9 Pr tt <br /> - <br /> _ _ ZE ( i <br /> Sampler(s): CC V <br /> R 9 U P— <br /> R e <br /> Z � <br /> i d Wo j ! <br /> Sampling Fee: Pickup Fee: e m J ? d i I <br /> Compositor Setup Date: Time. <br /> I <br /> Samp Location Description Date Time v' 'd <br /> Num I I Sampled I Sampled z r 2 in m m w I <br /> 0 Travel Blank "7-Z5 G 2 G X <br /> 1. Domestic Well s NJ ,-7---ZS' i G 3 P/G P ..DW SRC O . X . X <br /> Remarks Relinquished Date: Time: kcl' ed Date: Time: Relinquished Date: Time: <br /> - f7 & 6--,-1 g /�jS -1V/ /1—i <br /> 7 Day RUSH <br /> Received 4y: Date: Time: Received By: jhtc• Time: kcccivcJ By: Date: Time <br /> (:11 <br /> 706) 52 G1� <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Field Office <br /> 653 Corporation Street 2500 Stagecoach Road 563 E.Llndo Avenue Visalia,California <br /> Santa Paula,CA93060 Stockton,CA 95215 Chico,CA 95926 TEL:5591734-9473 <br /> TEL:805/392-2000 TEL:209/942-0182 TEL:530/343.5818 Mobile:559/737-2399 <br /> FAX:805/52 54 1 72 FAX:209/942-0423 FAX:530/343-3807 FAX:559!734-8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certificallon No.1563 CA ELAP Certification No.2670 <br />