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A CHI% 0?TUSf%Y?"LABffAT Al"LYM R ESTWORIF w <br /> IT/ E.MCON4433 North Market Boulevard,Sacramento,CA 95834 Purchase Order 129078 <br /> (916)928-3300 FAX(916)928-3341 Lab SEQUOIA <br /> Project Name Don Rogers Analysis Requested <br /> Project Number 8800391A/01050000 <br /> Project Manager Mark Capps N <br /> Company IT 1 EMCON 0000 <br /> Address 3939 Cambridge Road,Suite 220 <br /> Cameron Park,CA 95682 U <br /> Phone (530)676-6881 4 N <br /> FAX (530)676-6885 <br /> 00 ' <br /> Sampler's Signature w <br /> REMARKS <br /> Sample LAB Sample I ContamerTypes <br /> I D 1patq Time I D Matrix HCI Preservations <br /> M W-I R water 3 3 <br /> REI t IISIiED BY ECEI ED Y r RELINQUISH BY RECEIVED BY TURNAROUND REPORT REQ[liREIIfENTS <br /> REQUIREMENTS X 1 Routine Report <br /> Sign a n'h ignature ign ure Si t 24 hr 49 hr s day 11 Report(includes DUP,MS <br /> Sanded(—Iii is warkmgdrio) MSD,as required,may be <br /> Printed NLdnlc Printed Name Printed Name rm N Provide Verbal Preliminary Results charged as samples) <br /> Vqt0)-- y7- Provide FAX PrelimmeyResults III Data Validation RLporl <br /> Firm 100 <br /> Firm VFT/ <br /> Firm Q Requested Repori Dau (includes All Raw Data) <br /> 1 D /�jl412V A � (� � U C) Q FRWQCB <br /> Datc/Iime Date/Time e Date/Iime (MDLslPQLs/TRAC!N) <br /> R1,I INQUISHED BV RECEIVED BY Special Instructions/Comments Sequoia Analytical Container Types key <br /> 819 Striker Ave,Ste 8 40 ml VOA I <br /> Signatiirt, Signature Sacramento,Ca 95834 125 in]1 P6 2 <br /> 916 921-9600 500 int t PL 3 <br /> PrinJLd Name. Pnnti d Name Contact Rob Bobel 1 liter I IDPE 4 <br /> 500 nil glass 5 <br /> I'trni Finn I liter glass 6 <br /> 2x6 s!s ring 7 <br /> 1)1ltill init. Dale/1 nne glass Jar 8 <br />