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4lIlL' Torrentr re IYr- <br />483 Sinclair Frontage Road <br />Milpitas, CA 95035 CHAIN OF CUSTODY I LABWORKORDERNO <br />_Torrent: Phone: 408.263.5258 RESET q <br />+ FAX: 406.263.8293 v"t" " 0 r p l <br />yy `OTE:'SHADED�AREAS,A EQClR-TORRENTM'USEONLY;i -%� .5_ / .' .„ i.., <br />.:L"ARORATORY.-INCS",.,,.�.,r�.:o�u�h.,.,m <br />Company Name: Process Specialties <br />Location of Sampling: <br />Address: 1660 W. inne Road Bldg A ? <br />Purpose: Well Water Check - Total - no filtration <br />City: Tracy <br />State: CA <br />Zip Code: 95377 <br />Special Instructions I Comments: <br />Telephone: 1-800-533-8810 FAX: <br />I <br />REPORT To: Edward Morris SAMPLER: /n0+t� /i/rI1eL� <br />P.O. i EMAL: emorriseaprocesspeciAties.com <br />ANALYSIS <br />REQUESTED <br />REMARKS <br />Vatel-Q-BasicPlus- <br />oecial List - S395 <br />ellnquistsed y: P int <br />Date: <br />Tirtr� <br />TURNAROUND TIME: <br />SAMPLE TYPE: <br />REPORT FORMAT: <br />2 Relinquished By: Print: <br />La 10 Wart Days Q 3 Work Days ❑ Noon - N t Day <br />L]Sbrn Wates Q Air <br />Q OC Level IV <br />Date: <br />Lj 7 Work Days U 2 Work Days LJ2.8 Hours <br />❑ Waste Nater Ohr <br />O EDF <br />Q G.rdl Nater <br />D Etcd I EDD <br />I C <br />5 Work Days ❑ t Work Day 0 DOW <br />❑ Sal <br />yfgF <br />- <br />LAB ID <br />CLIENTS SAMPLE I.D. <br />DATE I TIME <br />SAMPLED <br />t OF <br />CONT <br />CONT <br />TYPE <br />rQ01({- <br />LUGLG -a, -Y/4&-7,5 <br />�/Z �/ <br />Well <br />I 250mLP <br />ANALYSIS <br />REQUESTED <br />REMARKS <br />Vatel-Q-BasicPlus- <br />oecial List - S395 <br />ellnquistsed y: P int <br />Date: <br />Tirtr� <br />Received By: Print: Y! N <br />Date: <br />w <br />2 Relinquished By: Print: <br />Date: <br />Time: <br />Receive ..' '" Print: <br />Date: <br />Time: ' <br />'1 <br />r <br />i <br />. <br />a <br />1 <br />i <br />ANALYSIS <br />REQUESTED <br />REMARKS <br />Vatel-Q-BasicPlus- <br />oecial List - S395 <br />ellnquistsed y: P int <br />Date: <br />Tirtr� <br />Received By: Print: Y! N <br />Date: <br />Ti <br />2 Relinquished By: Print: <br />Date: <br />Time: <br />Receive ..' '" Print: <br />Date: <br />Time: ' <br />Were Samples Received in Good Condition? �es [j NO Samples on Ice? Q Yes U NO Method of Shipment Sample seals intact? 0 Yes Q NO �1/A <br />NOTE: Samples are discarded by the laboratory 30 days from date of receipt unless other arrange -ments are made. _ Page of <br />Log In By: _ µDate' �u Log In Reviewed By, Daw <br />483 Sinclair Frontage Rd., Milpitas. CA 95035 r 1 408.263.5258 1 !.�x: 4013.263.8293 1 w—w.to-entlab.com <br />Total Page Count: 15 Page 15 of 15 <br />