Laserfiche WebLink
CHAIN OF CUSTODY <br /> ENVI•RONMENTAL AND ANALYSIS REQUEST DOCUMENT <br /> Lab N tuber: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> �y.�3q85 _ <br /> i <br /> Client: Live Oak GeoEnvironmental <br /> Customer Number: 3016608 <br /> Address: 407 W. Oak St. <br /> Lodi CA 96240 ` E <br /> rhor,e: (209)369-0375 Fax: - <br /> EmailAddress: abby@logelodi.com <br /> Contact Person: Abby RaccO <br /> Project Name:Roddan,23563 S. Manteca Rd., Manteca ?i t' p 3 F � '• a <br /> Purchase Order Number. <br /> t 0 <br /> Quote Number i l <br /> � �•� <br /> Sampler{s}: <br /> 'ColI . <br /> Sampling Fee: — -- Pickup Fee: _ <br /> 6 Y z z � Q <br /> m ^j �_ <br /> Compositor Setup Date: Time: <br /> cc <br /> Samp I Location Description I Date I Timec -d `ti `x^ _ s <br /> Num Sampled Sampled z r- a lin i' $ 01 lin a F. <br /> 8 i s I <br /> 0 ' Travel Blank 3 is-1 y /?'` G 2 G X : <br /> z <br /> j <br /> 1 Domestic Well hLWko( •3 1-)-/f r k G 3 =P/G P DW SRC O X X <br /> J t r g <br /> Jg33 <br /> rSF 3 w 14� <br /> ,. •�•- € ��, �, <br /> c <br /> 1 <br /> . r <br /> 1. •� -_� . <br /> Remarks Relinquished Date: Time: R shed Date: Time: Relinquished Date: Time- <br /> L4 Day RUSH <br /> r p.« 3fn �� j l 1'1 Gv <br /> asi <br /> Receiv By: Dat : Time: Received By: Date: Time: R ived By: D tc: Time: <br /> �-� 3 SKI Time: <br /> -7 <br /> Corporate Offices 8,Laboratory ratory Office 8 Laboratory Field Office <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Undo Avenue Visalia,California <br /> Santa Paul&,CA 93060 Stockton,CA 95215 Chico,CA 95926 TEL:5591734-9473 <br /> TEL:805/392.2000 TEL:2091942-0182 TEL:530/343-5818 Moblle:559/737-2399 <br /> FAX:8051525.4172 FAX:2091942.0423 FAX:5 30134 3-380 7 FAX:559f734-8435 <br /> CA NELAP Certification No.01110CA CA ELAP Certification No.1563 CA ELAP CeRKcallon No.2670 <br />