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CAMONIE ENVIRONMENTAL CHAIN-OF-CUSTODY RECORD LAB PROJECT . <br /> ,(, /� /� r (Se(e(��Reverlse for Instructions) NO. 7 <br /> PROJECT NAME --rkr IJL o f SAMPLERS l 114elj r) �i,J,eef SAMPLE CONTAINER SAMPLE DESCRIPTION CODES TAT CODES <br /> RI DESCRIPTION CODES A. Ground Water F. Oil <br /> PROJECT NUMBER .ae.. . 40.ml VOA Vial B. Surface water G. Waste t. standard <br /> (SI B. Glass Liter E. Brass Tube C. Leachate H. BlanWSpike 2. 4B Hour <br /> RECORDER - C. Plastic 506ml F.Other D. Rinseate 1. Other_ 3. 24 Hour <br /> (SIGN) O. Plastic Liter E. Soil/Sediment 4. Other <br /> NUMBER OF ANALYSIS REQUESTED LABORATORY USE ONLY <br /> CONTAINERS <br /> o AND <br /> '^ PRESERVATION $ f 88 z " ^ <br /> 08 t Sm ;I'a 8y 8 SAMPLE <br /> B v _ - €F "=ao NOTES ASSIGNED CONDITION - <br /> E' E- E - BOTTLE UPON <br /> DATE TIME SAMPLE ID "' h = k H =° NUMBERS ,RECEIPT NOTES <br /> Q. �� � X <br /> Zkr <br /> NOTES/MISCELLANEOUS ReH' uished by: (Signature) d BY! ig tur 2a�t Time <br /> Slfe.. : '-pe ar ,g <br /> Ll3 50 N Q t✓�w ], el' quished By: (Signature) ace ved Signature) D to Time <br /> �d-� '- L�• R1 /$linquishr By: (Signature...,,,_� Received By: (Signature) Date Time In PIP <br /> I <br /> Met .of Shipment Description of Other Chains-Of-Custody Dispatched By: (Signature) Date Time Received for lab By: (Sign Lure) Date Time <br /> Transport Container Transported with this 2 I <br /> /Q//ykµ/t///[T,�t[J� Chain (by Serial No:) //A,`1 <br /> 1/ <br /> Men <br /> -I ( � I//' J <br /> Send Lab Results to (Name): (Check Office Below) Verbals Requested: Yes ❑ No ❑ <br /> ;❑ PORTER ❑ SAN MATEO ❑ IRVINE ❑ ORLANDO ❑ OTHER <br /> TEL(219) 926-8651 TEL(415) 573-8012 TEL(714) 757-1755 TEL(407) 8567428 TEL <br /> FAX(219)9267169 FAX(415) 573-5654 FAX(714) 757-0960 FAX(407) 855-2595 FAX <br /> ❑ DENVER ❑ KING OF PRUSSIA ❑ HOUSTON ❑ MT. VIEW ❑ OTHER <br /> TEL(303) 790-1747 TEL(215)337-2551 TEL(713) 5561666 TEL(415)960-1640 TEL <br /> FAX(303) 799-0186 FAX(215)337.0560 FAX(713) 556-0666 FAX(415)960-0739 FAX <br /> CANONIE ENVIRONMENTAL LABORATORY - 212 FRANK WEST CIRCLE, SUITE A - STOCKTON, CA 95206 - TEL.(209) 983-1340 - FAX (c09) 983-0304 <br /> SERIAL NO. 03418 WHITE:Field Copy YELLOW:Project Copy PINK:laboratory Copy <br />