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CHAIN OF CUSTODY <br /> ENVIRONMENTAL AND ANALYSIS REQUEST DOCUMENT <br /> WMLOVTEST DESCRIPTION AND ANALYSES REQUESTED <br /> Client: Live Oak GeoEnvironmental <br /> Customer Number: 3016608 ' <br /> j ! <br /> Adarcss: 407 W. Oak St. <br /> Lodi, CA 96240 <br /> 209 <br /> Phone: ( ) 369-0375 Fax: i <br /> email Address: abby@logelodi.com <br /> Contact Person: Abby Racco c o <br /> ProeM Name:Sema, 76 W. Bowman, French Camp,CA �IRUSH�f <br /> Purchase Order Number: <br /> Quote Number: a p 9 <br /> Samplerfs): <br /> A`66� � N ! Z <br /> 04 I <br /> Sampling Fee: Pickup Fee: .K_ <br /> m to o z= Q. <br /> F <br /> Compositor Setup Date: Time: <br /> $ <br /> Sump Location Description Date Time <br /> Num I Sampled I Sampled z' r k�i t— t$rn a ¢ I <br /> 0 Travel Blank t-lo-tiI [a: S— G 2 G X ' <br /> 1 Domestic Well 2.-10-21 ,/o`fg G 3 P/G P „DW SRC O . X X <br /> i 3 4 <br /> Remarks Relinquished Date: Time. a mq 'had Dajt : Time: Relinquished Date: Time. <br /> A_ix� , LS 2111 Lr�I t <br /> 7 Day RUSH <br /> RciX Date: Time: Received By: Dat : Time: Received By: �c: T <br /> ,, <br /> Corporate ONleea&Laboratory Office&Laboratory Office&Laboratory Field Office <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Undo Avenue Visalia,Cellfomla <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 TEL:5591734.9473 <br /> TEL:8051392-2000 TEL:209/942.0182 TEL:530/343.5818 Mobile:559/737-2399 <br /> FAX:805/525-4172 FAX:209/842.0423 FAX:530/343-3807 FAX:5591734-8435 <br /> CA NELAP Certification No.01110C.,A CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />