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3- <br /> AM <br /> - CHAIN OF CUSTODY <br /> mftzwmfta@��%= www.fglinc.com AND ANALYSIS REQUEST DOCUMENT <br /> Client: Latitude 37 Partners LLC Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Customer Number: 3018454 Z <br /> Address: 20679 E. Hwv. 120 <br /> Escalon.CA 95320 <br /> Phone. (209)595-8348 Fax: m <br /> Email Address: Daul(@.franz1afamilv.com <br /> Contact Person: Paul Franzia <br /> Project Name: Nitrate Monitoring e <br /> Purchase Order Number: 1L� a � o <br /> Quote Number: <br /> Rush Analysis: ❑ 5 Day❑4 Day❑3 Day❑2 Day❑24 hour V ,� O C <br /> Rush pre-approval by lab(mitals): Z Q �8 <br /> C3 ¢ a <br /> Electronic Data Transfer: No❑State Client Other: £I N <br /> V o <br /> Sampler(s): CDm F Z z <br /> o <br /> Sampling Fee: Pickup Fee: $ 78 a E <br /> m <br /> Compositor Setup Date: <br /> Time: E <br /> Same Location Description Date Time 2 a m <br /> Num Sampled Sampled rn <br /> 1 Wellhead 3 b$lU G 1 P P DW X X <br /> Remarks Re' uith Date: Time: Relin 'had Date: Time: Rebquis Date: Time: <br /> 3 3 �r 2urfoiD <br /> Rtceivod e: Time: Received BY: e: Time: EJ ed e: T me: <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Office 6 Laboratory Office a Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Linda Avenue 3442 Empresa Drive,Suite D 9415 W.Goshen Avenue <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chlco,CA 95926 San Luis Obispo,CA 93401 Visalia,CA 93291 <br /> TEL:(805)392-2000 TEL:(209)942-0182 TEL:(530)343-5818 TEL:(805)783-2940 TEL:(559)7349473 <br /> Env FAX:(805)525-4172/Ag FAX:(805)392-2063 FAX(209)942-0423 FAX:(530)343-3807 FAX:(805)783-2912 FAX:(559)7348435 <br /> CA ELAP Certification No.1573 CA ELAP Cert fication No.1563 CA ELAP Certfficatlon No.2670 CA ELAP Certification No.2775 CA ELAP Certification No.2810 <br />