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WN <br />ENVIRONMENTAL <br />CHAIN OF CUSTODY <br />AND ANALYSIS REQUEST DOCUMENT <br />Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br />Client: Live Oak GeoEnvironmental <br />Cu+tamer Number' <br />3016608 <br />Address: 407 W. Oak St. <br />Lodi, CA 96240 <br />Phone: (209) 369-0375 Fax: <br />Email Address: abby@logelodi.com <br />Conlach Person: Abby Racco <br />Project Name: 7681 W. Linne Rd., Tracy N g 9 3' <br />Purchase Order Number. <br />Quote Numbcr. e <br />n. � <br />Samplcr(s):As v z E <br />s' P � R <br />acL@ F <br />Z L: <br />E� <br />Sampling Fee: ------ — — Pickup Fee: ° z z Q <br />Compositor Setup Darr. _Time: a c V <br />d N <br />i9 Z <br />Samp Location Description Date Time <br />35 <br />Num ( p ( Sampled I Sampled z' 1 S ' in t} / <br />S�H <br />0 Travel Blank jlL(�ZZ �• 5 � G X 2 G <br />1 Domestic Well 114/12. 1:457.' G 4 P/G P DW SRC O X X <br />7 Day Rush <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />TEL. 805/392-2000 <br />FAX: 80515254172 <br />CA NELAP Certification No. 01110CA <br />R7 uy: Da Time: Raet��I3y: <br />Office & Laboratory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />TEL: 209t942-0182 <br />FAX: 209/942-0423 <br />CA ELAP Certification No. 1563 <br />Time: <br />Office & Laboratory <br />563 E. Undo Avenue <br />Chico, CA 95926 <br />TEL: 5301343-5818 <br />FAX: 530/343.3807 <br />CA ELAP Centficallon No. 2670 <br />{Date: Time: <br />Field Office <br />Visalia, Califomla <br />TEL: 559/734-9473 <br />Mobile: 559!737-2399 <br />FAX: 5591734-8435 <br />