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CHAIN OF CUSTODY <br /> a ENVIRONMENTAL AND ANALYSIS REQUEST DOCUMENT <br /> Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> /Jo11J r - <br /> Customer Number 3016608 <br /> Client: Live Oak GeoEnvironmental <br /> Address: 407 W. Oak St. <br /> Lodi, CA 96240 <br /> Phone: (209)369-0375 Fax: <br /> Email Address: abby@logeiodl.com <br /> Contact Person: Abby Racco <br /> Project Name: Englent, 11808 N. Ham Ln., Lodi, CA � 3 3 � a <br /> Purchase Order Number. <br /> Quote Number: <br /> a o z i <br /> e O i <br /> tn <br /> Z <br /> Sampling Fee: Pickup Fee: _ m0 <br /> g y ¢ i Q <br /> J <br /> Compositor Setup Date: _ Time: <br /> N <br /> I <br /> Samp Location Description Date I Time e a c m o <br /> Num SLLampled Sampled z' a 63 m a s <br /> 1 Domestic Well �!2°i f I h.}C� G 4 P/G P DW SRC O X X <br /> I <br /> I � I <br /> Remarks Relinquished Date: Time: Rc` new ed / 'Uat 'Time: IlRelinquished Date: Time: <br /> vzq/26 i&o �J'1 �9 /7d7E) 13(J 0 `! <br /> R By: Date: Time: Recet d By: D te: Time: Received By: Date: Time: <br /> 19/a�� /.JoO � � /7°� C(� I017to 0 q <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Field Office <br /> 853 Corporation Street 2500 Stagecoach Road - 563 E.Undo Avenue Visalia,California <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 TEL:5591734-9473 <br /> TEL:805/392-2000 TEL:2091942-0182 TEL:530/343-5818 Mobile:5591737-2399 <br /> ,4 FAX:805/5254172 FAX:209/942-0423 FAX:530/343-3807 FAX:559/734-8435 <br /> ` CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br /> 11 <br />