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A080 PI� AN�, SUITE CI �r CHAIN-OF-CUSTODY RECORD - <br /> _ COlVppp '852 94520 "0/1 r3/UA4j Pit,$ AND ANALYSIS REQUEST 26588 <br /> _.liNvT sii rRt7ti (510 68a.78��--- �1 <br /> J Aeo �Urrr«-rnc (800) 43 -It'mir,-&z 1 Ch qJ1 sra <br /> ompany Name Y« Phone <br /> TirAi C" fi s zX, r R/.a+ 9 7 <br /> C�' ,r,f FAX# ❑ <br /> ompany Addre s r t © ❑ <br /> �/Site local,on I/ ur m <br /> cl <br /> otect Manager Clrenl Project fl] h Y ❑ Ln o � U <br /> I7f r/ ( s a <br /> NAME y/�U ['/,, tl / ;C��? r- o a cn cn °6 a r1- <br /> illesl That the proper frpld sampling Sampler Name(Pnnt) ❑ ❑ ❑ z z 0 O ❑ ^ cc <br /> ocedures were used during the collection o co ❑ <br /> �uL'e t � 3 a 0 w ❑ ,n ❑ o ❑ d E' ❑ 0 <br /> these samples an a C <br /> O Q En ❑ � .O N � � U t k U O <br /> matrix Method cQi ro u- m 5_ �^ o o a h a a ❑ L <br /> Field GTi;L m Sampling m a a m a m W ❑ m ❑ o C ❑ <br /> Sample b Preserved P 9 a N ❑ [6] w a ❑ ❑ 40 C �' <br /> Lab N p c G ❑ W W ❑ a ❑ <br /> D o a W V '�' vN W A a W m CD <br /> ❑ ❑ ❑ a a ❑ m is ,n *n R ❑ <br /> (Lab Use only) U w ¢ � <br /> O r`n O <br /> a Q O d W a F W Y� t7 o C � ey m X <br /> H U Z a s W W m a a a a a a f? ej <br /> n o <br /> f 3 m •i v� L O r 2 v oN m m '' �. - Q o a n_ Q a n. a s <br /> IIJ�/ > z Y O W W LU W ED <br /> W lU W W W F-- W U J O U <br /> �,- <br /> �I�Ly/t� - <br /> �r/'� <br /> h,�<L�S✓J r — <br /> - /a-3a — — <br /> 0.1 <br /> TAT Special Handling SPECIAL DETER <br /> CTION LIMITS _ <br /> �T p{ REMARKS rM <br /> iarq(24 hr) ❑ GYEL Contac) H y(, $ f/'�/h�01 U v02 <br /> oedited t48 hit ❑ OunlnlConrrncl K , „ ✓ti _J <br /> Business Days ❑ Coniirmallon N <br /> her POM SPECIAL REPORTING REQUIREMENTS <br /> siness Das ❑ Lab Use Only Lot>y Storage Location <br /> CIA I QC LEVEL <br /> UE❑ CLP❑ OTHER <br /> FAX Work Order B <br /> Relurshed by Sam pfe.7 <br /> ale Time Reserved by <br /> U S TO D Y Relingwshed by <br /> bite-Time Received by <br /> RECORD <br /> Relinquished by <br /> pate Time Received by Laboratory <br /> �I � '. ` * <br /> 7/91 q-7-93 - p r <br /> 3. 30 �� Waybill /�Og'L C' ' <br />