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ENVIRONMENTAL CHAIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCUMENT <br /> Lab Numb r: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> 2�22�l <br /> Client: Live Oak GeoEnvironmental <br /> Customer Number: 3016608 <br /> Address: 407 W. Oak St. - <br /> Lodi, CA 96240 <br /> Phonc: (209)369-0375 rax: �F <br /> Email Address: abby@logelodi.com <br /> Contact Person: Abby Raced <br /> Project Name:Ahern Truck Stop, 29700 S.Ahern,Tracy 11 <br /> rr <br /> Purchase Order Number: o s i <br /> o <br /> Quote Number: a > e O t <br /> Samplcr(s): <br /> QM YZCL <br /> �i <br /> CD <br /> Sampling Fee: Pickup Fee: g h o <br /> i <br /> Compositor Setup Date: -----_---- Time: z <br /> Samp I Location Description I Date I Time <br /> Num Sampled Sampled z k 8 W' m rn 3 a <br /> 0 Travel Blank Z 13-z v !o,s r G 2 G X _. <br /> 1 Domestic Well f3-Zo lv'S-'S' G 4 3 ;P/G P DW SRC O X X <br /> . F <br /> V - <br /> JZ <br /> tj S" <br /> RCI11arkS Rclinquishc/d� Date: Time: L Relin ishcd Date: Time: Rclin wished ate: Time: <br /> �(Q�Jr/ /���it/� Z /3—2 D •2 T 'd <br /> _4K_7-Day-R-•. vv Received By:�— Date: Time: Rcetivcd By: ate: Time: Recei-cd Hy: Date• Timc: <br /> ILP <br /> Corporate Offices&Laboratory Ofil &Laboratory Office&Labo tory Field Office <br /> 853 Corporation Street 250D legocoach Road 563 E.LErtdo Avenue Visalia,California <br /> Santa Paula,CA 93060 Stockton,CA95216 Chico,CA 95926 TEL:5591734-9473 <br /> TEL.805/392-2000 TEL:209t942-0182 TEL:530/343-5818 Mobile:559/737.2399 <br /> FAX:805/525-4172 FAX:2091942-0423 FAX:530/343-3807 FAX:5591734-8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />