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CHAIN OF CUSTODY <br /> Imp ENVIRONMENTAL AND ANALYSIS REQUEST DOCUMENT <br /> Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> A31-1j6 9 <br /> client: Live Oak GeoEnvironmental <br /> j <br /> Customer Number: 3016608 <br /> Addr�xs: ;; <br /> a 1 <br /> 407 W. Oak St. 4 <br /> �l t <br /> Lodi, CA 96240 <br /> Phone: (209)369-0375 Fax: € i <br /> Email Address: abby@logelodi.com 3 <br /> Contact Person: Abby Racco m <br /> Project Name: Pacheco, 172 N. Patton Ave., Stockton, CA m <br /> Purchase Order Number: 3 a <br /> a F _ <br /> Quote Number: o> - o <br /> 3 � 8 .ZRU S H <br /> Sampler(s): r 9 N <br /> o <br /> CCLCC,0 <br /> Cr <br /> m <br /> 21 <br /> a og <br /> Sampling Fee: ._ Pickup Fee: m' m '!' ?__' <br /> Compositor Setup Date: _ Time: cg a 3 N g h V e <br /> (2. co ,= e <br /> Samp Location Description Date Time <br /> Num I ( Sampled I.. Time <br /> z' a M $ w a <br /> 1 Domestic Well 3�3 7u? 3:DO�.,G 4 P/G P DW. SRC O . X . X <br /> • <br /> 5 <br /> Remarks Reli juished Date: Time: I Rel' shed Date: Time: Relinquished Date: Time: <br /> ►/n /"% 3I�3Cj�2G f�:31 ��� /7� ( 3l Z.� <br /> Qy: etc: Time , Received By: te: Time: Received By: Date: "rime: <br /> PIe�SL 3/o%�to �.�� � '��o4" 1-7� � �/3�/Z6 <br /> Corporate Offices a Laboratory Office&Laboratory Office&Laboratory Field Office <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.LindoAvenue Visalia,California <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 TEL:5591734.9473 <br /> TEL:8051392-2000 TEL:209/942.0182 TEL:5301343-5818 Mobile:559/737-2399 <br /> FAX:805/525-4172 FAX:2091942-0423 FAX:530/343-3607 FAX:559/734.8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2870 <br /> 16, <br />