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CHAIN OF CUSTODY <br /> E1`IVI RON M ENTAL AND ANALYSIS REQUEST DOCUMENT <br /> Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> 1213) 2 Coil- <br /> Client: Live Oak Geo Environmental <br /> Customer Number: 3016605 = <br /> Address: 407 W. Oak St. <br /> Lodi, CA 96240 j <br /> Phone: (209)369-0375 Fax: ' <br /> Email Address: abby@logelodi.com <br /> Contact Person: Abby Raeeo <br /> Project Name: �� ,�G.� �}Ol w O*L.0 Sk it <br /> aCT of <br /> Purchase Order Number: r C.A o <br /> m <br /> Quote Number12 <br /> a � <br /> N iT g _� <br /> Sampler(s): <br /> 24o <br /> d . t+� <br /> Sampling Fee: Pickup Fee: o y `it -z_ �1' `• I <br /> Compositor Setup Date: Time: iR 3 s g <br /> c3 r� y� 5 m • <br /> samp Location Descrip tion Date Tine Z ; <br /> Num I I Sampled I Stlmpled 1 z' 8 u3 r a3 d5 n l <br /> 1 �,,;..ww K✓ -2'1 zr, ro .� G 1 P <br /> j <br /> Remarks � }t Relinquished Date: Time: Relin uished Dat.. Time: cl' fished Date: Time: <br /> 0.3 C-TC0 <br /> Corporate Offices&Laboratory Officlii&Laboratory Ottice&Laboratory lel ce <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lindo Avenue Ysalie,California <br /> Santa Paula,CA 03060 Stockton,CA 95215 Chico,CA 95926 TEL:5591734-9473 <br /> TEL:805/392-2000 TEL:209/942-0182 TEL:530/343-5818 Mobile:5591737-2399 <br /> FAX:8051525-4172 FAX:2091942.0423 FAX:530/343-3807 FAX:559!734-8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA FLAP Certificatlon No.2670 <br />