Laserfiche WebLink
-m_,;- ?--�--� CHAIN OF CUSTODY <br /> www.fglinc.com AND ANALYSIS REQUEST DOCUMENT <br /> Client: Live Oak Geo Environmental Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Customer Number: 3016608 <br /> Address: 407 W.Oak Street <br /> Lodi. CA 95240 <br /> Phone: (209)369-0375 Fax: (209)369-0375 <br /> Email Address: welChlodiO.vahoo.Com 0 <br /> Contact Person: David Welch <br /> Project Name: �v%.wgL 4-✓ L9 I a <br /> Purchase Order Number. £ 5C <br /> Quote Number. o _ <br /> Rush Analysis: E] 5 Day[:]4 Day❑3 Day❑2 Day❑24 hour a a <br /> Rush pro-approval by lab(utaals): t <br /> Electronic Data Transfer: ❑No❑State F]Client Other: <br /> Q m x <br /> Sampler(s): <br /> Sampling Fee. Pickup Fee. <br /> Composaor Setup Date: Time: <br /> Samp Location Description Date Time z � >✓► a3 d <br /> Num Sampled Sampled <br /> �QCu►�woe}v �G") W• 5'19-i� (0'•(30 r� C1 � P 1` <br /> c" <br /> Remarks Relinquished Date: Time: Refmquish Date: Time: Relinquished Date: Time: <br /> Receive Date: Time: R e Dale: Time: Received By: Date: Time: <br /> A6 <br /> Corporate Mom a Laboretery ani•a tasaaeo.y Of m a Labara" office a Laboratoo y of log a Laboa to y <br /> 853 Corporation SIT" 25W Sta99ooaeh Road 583 E.UndoAvertue 3442 Empre"Drive.Suite D 9415 W.Goshen Avenue <br /> Sante Paulk CA 93080 Stod2on.CA 95215 Chico,CA 85928 San We Obispo,CA 93401 VhSW CA 93291 <br /> TEL:(805 192-2000 TEL:(208)942-0182 TEL:(530)343-W18 TEL(805)783-2940 TEL($59)734-9473 <br /> Erre FAX:(805)625-4172/Ag FA)C(805)392-2003 FAX:(209)942-0423 FAX:(630)3433807 FAX:(805)783-2912 FAX:(65%734-8435 <br /> CA ELAP CerWh aborr N0.1$73 CA ELAP CerH0ee5mt No.1583 CA ELAP Certl catim No.2670 CA ELAP Cerocation No.2775 CA EIRP Cei focaft No.2810 <br />