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CHAIN OF CUSTODY <br />EI`IVIROI`IMEI`ITAL <br />AND ANALYSIS REQUEST DOCUMENT <br />Number: <br />TEST <br />DESCRIPTION AND ANALYSES REQUESTED <br />+Lab <br />Client: Live Oak GeoEnvironmental <br />Customer Number: 3016608 <br />Address: 407 W. Oak St. <br />Lodi, CA 96240 <br />i <br />phone: (209) 369-0375 Fax: <br />I <br />- <br />Finat7 Address: abby@Iogelodi.eom <br />Contact Perwn: Abby Racco <br />m <br />s <br />Project Name: Navarro, 336 E. Watters Rd., French Camp), <br />7S <br />a <br />�_ <br />s <br />a <br />Purchase Order Number. <br />Quote Number: <br />o O <br />o <br />a <br />r <br />Sampler(s): <br />peer <br />$ 3 9 <br />v <br />✓. �, t <br />i <br />at,(o <br />z <br />Sampling Fee: _ Pickup Fee: <br />- j� ZE m <br />J <br />z 'a <br />I <br />Compositor Setup Date: _ Time: <br />Stump I Location Desrnption I Dale I Time <br />o <br />{+ <br />I <br />x A <br />Num Sampled Sampled <br />z r- a in r rR <br />m <br />N , <br />�0 <br />0 Travel Blankq �u 10 : 30 <br />G 2 G <br />X <br />1 Domestic Well q/3o10 3Q <br />G 4 P/G P DW <br />SRC O <br />X X <br />, <br />Remarks <br />Reliqquished Date: Time: <br />l7'.; <br />Retwauished <br />� <br />Date: Time: Rclinquished <br />CDb Time,61/-3921 <br />1-30D <br />"l <br />Reccty y: ate: Time: Received By: Date: Time: <br />916V/909r iasr 9��1,-60f <br />� •cd By: <br />Date: Time: <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Field Office <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Undo Avenue <br />Visalia, California <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />TEL: 559/734-9473 <br />TEL: 805/392.2000 <br />TEL: 2091942-0182 <br />TEL: 530/343-5818 <br />Mobile: 559/737.2399 <br />FAX: 805/5254172 <br />CA NELAP Certification No. 01110CA <br />FAX: 209/942-0423 <br />CA ELAP Certification No. 1563 <br />FAX: 530/343-3807 <br />CA ELAP Certification No. 2670 <br />FAX: 559f734-8435 <br />