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r - r - C_ rnT -4 <br />ICE <br />GES, <br />`�Jfl <br />CSC <br />Version 6.0 <br />10112/2006 <br />'i'k( 4 J kTy 13 �' <br />r t{ t st,N� a t s !ti'"Nw e,,s ,,. Oji aF <br />`S ;,�ha.inf of fCustodyj:n t ` <br />cw�t i <br />y�riRS� i ?Ca t, �"t��rt F 1 . ..xip� f. wtrr r <br />f '��.- <br />'` �ti <br />17478 <br />17478 <br />r 1 <br />L!x��"s sL w Y 1111111 VIII VIII VIII VIII IIII IIII <br />r;.y <br />v ta�y <br />Send Results to: <br />Turnaround <br />Time <br />E <br />K.NEWMAN <br />Field Contact <br />Data Package Required: ®Normal ❑CLP <br />Reporting level: ❑ Level 1 Level 2 ❑ Level 3 <br />K. NEWMAN <br />®R <br />❑ N <br />CES <br />DQE; <br />N/A <br />3293 _ 59 <br />LLNL Account # <br />- <br />NORMAL SAMPLING <br />Project Name <br />Tank Volume N/A liters <br />❑ RETURN UNUSED SAMPLE TO CLKENT <br />❑ EDD Required (data from off-site labs only) <br />Client ID RHWM <br />L- 874 phone 42852 <br />Copy: <br />Condition Upon Receipt: ❑No Discrepancies <br />❑Condition/Variance <br />Tests / Preservation Codes <br />Circle Preservation Code for On-site Analyses <br />Additional Instructions: <br />Client Sample <br />Identification <br />Date <br />Sampled <br />Time <br />Sampled <br />Bldg <br />RAD <br />(Y/N) <br />Matrix <br />Code <br />Gen <br />Code <br /># of <br />Bottles <br />o <br />Sample Composition <br />LL <br />u <br />8875 -CW 1 <br />8/25/08 <br />1100 <br />875 <br />N <br />AQ <br />WS <br />2 <br />R <br />C <br />CONDENSATE WATER <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />N I—_Z_7111 n,,. TL... / Ir-. "ioe% kw 1, Dao- Time <br />Sampled and Relinquished fl - z5 -0[r C� <br />( J <br />Received by: <br />Relinquished by: l,_ <br />Received by: <br />Relinquished by: <br />Received by: <br />CES phone # (925) 422.6605 or (925) 42L-211611 <br />v c pa,o .o, 1.. 1. o,,., ow,.,..... <br />"The worker certifies that the Standard ES&H Roles, Responsibilities and Authorities defined by Service Category I described by Section 4.3.1 or Document 2.1 "Laboratory and ES&H Policies, General Worker <br />Responsibilities and Integrated Safety Management," apply and that th e I WS or IWSs authorizing the work have the appropriate controls for the hazards involved in the task/analysis." <br />For document control purposes, user SHALL ensure that all working copies arc identical to current electronic version, <br />http://cms.11nl.gov/ces/QA-Docs/QA-Docs.htmi <br />