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CHAIN OF CUSTODY <br /> ENVIRONMENTAL AND ANALYSIS REQUESTDOCUMENT <br /> �La/b{�Number- TEST DESCRIPTION AND ANALYSES REQUESTED <br /> w.<.„....wy.�....m w. ......r.�..F. a ..w.w...gym ...w w.m.�..n <br /> Ichent: Live Oak GeoEnvironmental <br /> f <br /> ,CuatmnerNambn: 3016608 <br /> Address: <br /> 407 W.Oak St. Et i I <br /> Lodi, CA 96240 ? s f t <br /> Phone: Fay: p <br /> (209)369-0375 <br /> i <br /> t <br /> FEmail Address: abby@logelodi.com <br /> Contact Person: Abby RacCO <br /> Project Name: 24363 N. Leadstone Dr.,Acampo P 9 <br /> Purchase Order Number <br /> i c.7 <br /> 7 <br /> Quote Numbero b <br /> d - ? 4 } <br /> €Saritkdsj: u o v' <br /> ir <br /> i tJ <br /> ,Sampling <br /> P Fee: tree: a s m Eicc <br /> Compositor Setup pate _.- Time. ; a` E ( t i € i t <br /> o v _ E <br /> €Samp Location Description Date Time E z h+ C. ¢ t <br /> rS <br /> Num( Sampled i Sampicd z S r tTi t3 t <br /> _ �- <br /> o Travel Blank �2�Z1 11,00 G 2 G � �s X x � <br /> 1 Domestic Well q2 /Z� t(:db G 4 P/G P DW SRC O X X s <br /> u� <br /> IT <br /> Remarks R yuis )ate. Time; fished Time: kclinquished Date: Time: <br /> i" (00 <br /> By: Dat e• Time: Received B,v: Date: Time: Received By., Date: Time: <br /> 1355 <br /> Corporate Offices&Laboratory Office&Laboratory Office&Laboratory Field Office <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.Lindo Avenue Visalia,California <br /> Santa Paula,CA 93060 Stockton,CA 95215 Chico,CA 95926 TEL:5591734-0473 <br /> TEL:8051392-2000 TEL:209/942-3182 TEL:6301343-5918 <br /> FAX:805/5254172 FAX:209/942-0423 FAX:530/343-3807 FAX,55W. 34-84358 <br /> CA NELAP Cediftcation No.01110CA CA ELAP Certification No.1563 CA ELAP Certification No.2670 <br />