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<br />www.fglinc.corn <br />CHAIN OF CUSTODY <br />AND ANALYSIS REQUEST DOCUMENT <br /> <br />ENVIRONMENTAL --"=7 AGRICULTLRAI. <br /> <br />Aiudytical Chemists <br /> <br />Client: Live Oak Geo Environmental <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: welchlodiavahoo.com <br />Contact Person: David Welch <br />Project Name: /4 ?q5 6 (girl (In e") 1 ra-ej <br />Purchase Order Number: <br />Quote Number: <br />Lab Number: <br />r /gs3A/ q7q <br />TEST DESCRIPTION AND ANALYSES REQUESTED <br />6 <br />1 <br />I <br />1 <br />1 <br />8 Type of Containers: (0)01ass (P)Piestic (V)V0A (MT)14 all Tube i <br />E <br />1 <br />1 <br />if <br />ii <br />i <br />i 1 <br />t I (S) Son (SLO) Sludge (Ste) Seed (0) 03 I Sect (Sys) System (SRC) Source (W) Waste Beet (ROLIT)Rixdfne (RPT)Repeat (OTH)Other (RPL)Replace (LT) Lad Tissue (PET) Peels Tissue (PRO) Pradice Paesentative: (1) NaOH + ZnAco (2) Na0H, (3) Ha (d) 1121304, (5)11403, (8) Na28203. (7) Other Rush Analysis: <br />Rush pre <br />Electronic <br />5 Day 4 Day 3 Day 2 Day <br />-approval by lab (finials): <br />24 hour <br />Data Transfer: No State DCbcnt Other: <br />Sampling <br />Compositor <br />.-----' <br />Fey: Pickup Fee: <br />Setup Date: Time: <br />Samp <br />Nuns <br />Location Description Date <br />Sampled <br />Time <br />Sampled <br />I ., • tc-,-friz., (I)6-t-t. 4 lc t 11./6) _. DU) "A <br />, <br />Remarks <br /> <br />Relinquished Date: I Time: <br />, ----- <br /> <br />joie 6-1-4-6 -4/i 0 M /.3"1.) <br />.Re ' uished tc: Time: <br /> <br />1A129 /76( <br />elinquished Date: Time: <br />0.40 7 Date: Time: <br />4.1, Po /32d <br />Received By: iADia?: Time: <br />I / r /7e 6 <br />eV Li : <br />,;.; i <br />ti \ I:1\1\ 0 <br />04 <br />time: 0 <br />ii„ t <br />Corporate 019oes a Laboratory <br />853 Corporation Street <br />Santa Paula. CA 93060 <br />TEL: (805)392-2000 <br />Env FAX (805)525-4172 / Ag FAX: (805)392-2063 <br />CA ELAP Certification No.1573 <br />Moe a Laboratory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />TEL: (209)942-0182 <br />FAX: (209)942-0423 <br />CA ELAP Certification No. 1563 <br />Moe & Laboratory <br />563 E. Undo Avenue <br />Chico, CA 95926 <br />TEL: (530)343-5818 <br />FAX: (530)343-3807 <br />CA ELAP Certification No. 2670 <br />Office & Laboratory <br />3442 Ernprese Drive. Sufte D <br />San Luis Obispo, CA 93401 <br />TEL: (805)783-2940 <br />FAX: (805)783-2912 <br />CA ELAP Certification No. 2775 <br />Office & Laboratory <br />9415 W. Goshen Avenue <br />Visalia, CA 93291 <br />TEL (559)734-9473 <br />FAX: (559)734-8435 <br />CA ELAP Certification No. 2810