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V P u c <br />;ample ID: 1739857-09 WQENG_5PECIAL <br />.8 -Nov -2017 11:00 1L GRAa_P_4^C/HNO3 <br />60 <br />2M. 41 <br />LABORATORY CHAIN OF CUSTODY <br />ontainer ID: 10mena East <br />REPORT 1739857-09-1 <br />a <br />Sample Receiving Desk (650) 871-2638 SEWPCP-Metals <br />w Mc .. <br />WM1TGP $ P.POW Eft <br />cwt„„ N/wTEF <br />Tests: <br />SEM _245.1_DW, SEM_245.1_DW_PREP <br />Requested By: A,7- <br />Send Report To: M. <br />Agency:X/�/F <br />Sample Collector (Print) PoseJ7e <br />(Signature) <br />Sampling Date(s): ✓e rB <br />Relinquished By (Signature) <br />i Received b Y <br />Si nat - <br />( g �e�`--�—��-�— Date: T <br />Relinquished By: (Signature) <br />Received b y <br />Si natLA <br />( 9 ) Date: <br />- - FOf2LABORATORY USE ONLY: <br />Circle or Add Analysis Requested <br />CO Digital Cdonmoter QC Check.(Total CL; <br />Rnr Feria -TC i EC I FC I ENT; HPC -PCA / HPC-R2A <br />Method of Transport' <br />- -. <br />Sample Condition. Upon Receipt (Check appcopriate boxes) <br />Alkalinity (Chloride! Hardn=_ (TDtalj •' HaNness (Calcium) <br />GPD telex Bax ,”. 7�Gre2� - - <br />-- <br />(Check oriej - <br />- _ <br />PH! Condunwayl Turbidity; Fluoride/Ammonia <br />QC <br />Result � <br />Ime Valu <br />--. Range - <br />Mrlit <br />Chilled Y:_Cautainer'Intact <br />[ <br />Nitrate•Niirteigulfatelo¢hD-Phosphate <br />_ <br />SUR <br />m <br />(+1'10%T. <br />- <br />- - <br />Bromate l Bmmite/ Chlorate l Chlorite <br />Moccasin <br />T -e° of (2 6°C). <br />P'TH+•11HAAIVOCI <br />_ <br />Samples match COC -Y[ :. ] NJ `. ].: <br />TOC/Colors Ocor/UV254;MBAS <br />BEAN <br />— <br />0 <br />-- <br />`- <br />MTBE/NDMA <br />Counc/Cither <br />Sealed-Y I 1 <br />N [ } <br />}Headspace (VOA) Y[ ] N [ ] <br />Parasites (Crypto,'Giardial <br />STD1 <br />O✓9 <br />O.2/ <br />- <br />-�-- -- <br />- <br />Consumer Comp6i2ints <br />SAMPLE LOCATION <br />FIELD DATA <br />Leak!Seepage Analysis <br />STD2 <br />- <br />- <br />tvletcls A/fuccsn <br />SOURCE <br />GATE <br />TIME <br />RES. <br />TEMP. <br />other <br />'Vuater <br />STD3 <br />' <br />COLLECTED <br />CL2 <br />(°F) <br />Type <br />COMMENTS 1 METHOD I OTHER MEAS. <br />- <br />2 <br />e✓ /8 / <br />9: o® <br />J+ <br />J� <br />ski%sI?ec% �ra� �`/# t <br />S ec-s et-/ <br />ee !8 s <br />9:r� <br />X <br />A <br />9r0eC.s 4i <br />se rP di <br />oi: 5{T'e4- <br />S' <br />/o 0o <br />X <br />X <br />- I <br />TYPE OF WATER. R = Ravi Water. TIN = Treated Water O = Other (Indicate Type) <br />