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� EnVIRONMEnTAL CHAIN OF CUSTOD_ <br /> AND ANALYSIS REQUEST DOCUMENT <br /> Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Client: Live Oak Geo Environmental r <br /> Customer Number: 3016608 , <br /> Address: 407 W. Oak St. <br /> Lodi, CA 96240 <br /> Phone: (209) 369-0375 Fax: <br /> Email Address: abby@logelodi.com <br /> Contact Person: Abby Racco �ot_ <br /> Project Name: Rp iMw�t.K+� '}01 w , o,�. $4 . (pmt: jl S of <br /> o <br /> Purchase Order Number: r CA o € o t <br /> Quote Number iii g „ O S <br /> g z <br /> sampler(s): gm j 3s 9 czL R <br /> (24 <br /> -I✓J �E � .megg ��� � � � * � � 1 <br /> Jo O ] Y <br /> L iLi <br /> tl ' 0 '?z 0_ <br /> 6 i <br /> Sampling Fee: Pickup Fee: m it <br /> g 3 z d tz Ir d <br /> Compositor Setup Date: Time: a v g <br /> 0 <br /> Samp I Location Description ( We ( Tune g 13 <br /> t o <br /> Num Sampled Sampled ,l z' 8 r,�rL° rR Z <br /> ._ <br /> 1 11Zw;�Aw&--lrw 1-2-1-LI 10-.0y G 1 P <br /> i <br /> Remarks Relinquished Date: Time: Rclin u'shed Date: Time: el fished Date: Time: <br /> Waof AA <br /> - - <br /> Corporate Offlces&Laboratory CMOs 8 Laboratory Office 8 Laboratory lol H ce <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.LindoAvenue Visalia,California <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 TEL:559/734-9473 <br /> TEL:805/392-2000 TEL:209/942-0182 TEL:530/343-5818 Mobile:559/737-2399 <br /> FAX:805/5254172 FAX:209!942-0423 FAX:530t343-3807 FAX:559!734-8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />