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i l i i i i ti i i i i <br /> ir <br /> 720 Olive Drive,Suite D <br /> J(iJV <br /> Davis,CA 95616 <br /> Lab 530 297 4800 <br /> NALYTICAL ctc Fax 530 297 4803 Lab No �j Page I of <br /> Project Manager Phone No <br /> Joe K R u, Q9 3 5 -3 z 5 o Chain-of-Custody Record and Analysis Request <br /> le-Company/Address FAX No r— For Lab <br /> R aiv, a e �K v t r a h tvve K I (9 16 35'f- I� 8 6 Analysis Request F use only <br /> Protect Number PO No Project Name ,,; o o WET(x) <br /> -- S kF f a h o'S Crgks S ti t(o l C <br /> 02 TOTAL(x) <br /> Project Location Sampler Signature N 3 <br /> o m ai <br /> Container Method _ <br /> Sampling (Type/Amount) Preserved Matrix — a a v N z <br /> a, 0 <br /> J C7 o y y Q N <br /> 0 O M ca <br /> ¢ cn 0 �_1 2 m a� m m CD a a <br /> gf/1 Co = Vi N p} OY W N <br /> u, ro Co 00 <br /> Sample E o z w o ¢a a o 0 0 o a n¢ N <br /> Designation Date Time Nt m _ _ z 3 m m � in t- tn r� uu W 0 <br /> M W - 1Gt4 10 1145 X u W <br /> MW-3 ass x x w X -X <br /> MW -7 1 taps x x W X X - 03 <br /> I <br /> Relinquished by Date Time Received by Remarks No t e S a tmf l e O v A e r C-0 k f n Cle, <br /> CMw -i, MW- 3 mw-2 <br /> n��A YI I Relinquished by Date Time Received by Email address <br /> ❑ doc IJ As ❑ txt ❑other <br /> Relinquished by Date Time Received by Laboratory Bill to W h t k t F KV l y d h M-tK to 20 9)5 33-0-f 3$ <br /> /Ir/17" 12-16 �Cf �P} •t0K 5t.I TVR C9 953T6 <br /> Distribution White-Lab Yellow-File Pink-Originator M q r t a- COC fhb(8198) <br />