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Time: <br />pate:/ Time: <br />175 343i 17 <br />Office & Laboratory <br />563 E. Lindo Avenue <br />Chico, CA 95926 <br />TEL: 530/343-5818 <br />FAX: 530/343-3807 <br />CA ELAP Certification No. 2670 <br />Time <br />Dat Time: <br />leld ce <br />t <br />Visalia, California <br />TEL: 559/734-9473 <br />Mobile: 559/737-2399 <br />FAX: 559/734-8435 <br /> <br />CHAIN OF CUSTODY <br />AND ANALYSIS REQUEST DOCUMENT , ENVIRONMENTAL <br /> <br />I Lab Number: I TEST DESCRIPTION AND ANALYSES REQUESTED <br />443 15Y <br />Client: Live Oak GeoEnvironmental <br />Customer Number: 3016608 <br />Address: 407 W. Oak St. <br />Lodi, CA 96240 <br />Fkma: (209) 369-0375 Fax: g' <br />Email Address: abby@logelodi.com IA g <br />Contact Person: Abby Racco <br />1 <br />r §- : 2 0 <br />Project Name: 8458 E. Jahant Rd., Acampo, CA <br />Purchase Order Number. <br />1 F a 6 <br />Quote Number > <br />g F_ <br />Sampler): ti 11 EF-g <br />Pdesr R.CA-C4/0 a 'e <br />@gg gi 1 X 9 8 . 1 ,, , 6 , i 4 . g 5t 5 . ,.. ., r Q Sampling Fee: Pickup Fee: 13. ..@ F .. 0 x ‘i .IE * E2- Z <br />o_ <br />—. E; z ..s <br />Compositor Setup Date: Time: A r§ 12 a 1 15' II - <br />Samp I Location Description <br />I Sampled <br />Time <br />Num Sampled d I 1. I .- <br /> <br />E & a ,_ . A a a , <br />4/5/1. G . 2 .. G 0 ' Travel Blank X . <br />Domestic Well .4/5/21 1106 G . 3 :PIG P •OW, SRC o , - x - x <br />,1 <br />• 1,--t . `— <br /> <br />Relinquished t Time R,Iuaqsished <br />10..t j)0„. ct/q21 /4- kC7 <br />/Date: Time: <br />11/5ACGL / <br />Office & Laboratory <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />TEL: 209/942-0182 <br />FAX: 209/942-0423 <br />CA EL/SF Certification No. 1583 <br />Remarks <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />TEL: 805/392-2000 <br />FAX: 805/525-4172 <br />CA NELAP Certification No. 01110CA <br />Received Lly: