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�r"�1309 <br /> RIEDEL ENVIRONMENTAL Chain of Custody Laboratory: p2tZlSlO Date: 13 <br /> SERVICES INC <br /> Request for Analysis °n` —\t <br /> Page: <br /> 4138 Lakeside Drive, Richmond, California 94806 ZZ t1 -t, <br /> Phone: (510) 222-7810 Fax: (510) 222-6868 Phone: Of: <br /> PROJECT INFORMATION ANALYSES CONTAINERS <br /> Project Manager: ti5 D" Project Name: S��t;J t o 0 <br /> C. 5�J 122-7 STGC k�,tai o <br /> Fax Results to: At. m _ N E c <br /> _ x u7 �.. Z o <br /> Also to: �— At: — Project N __ wN uao + u~ c.' o <br /> o nr rn <br /> Send Report to: S P.O.N 'C% \ � a;n u E 40 u 0 a s ri u u 0 `� <br /> Sample Team (prin L e-RkS _ (SLQ"TT C%+(L.�S •-oifi rn c b o °u a ^o a, a <br /> vO r'1 U\ EN 00 u,} •.N u.+ O" '3 n > ai U <br /> cW wO oC' cN O� m UO �O J O <br /> O h\ 0rA Q� 2� rn� u\ O j c VI VI <br /> t i n0 u e 0 0 .60 <br /> 0 C� b <br /> (signatures): (nEQ(ZT _N u a u ° <br /> 0O Orn Q n0 �O N ON -rt) U O O mN ,9 O <br /> rA M l a O r° O l0 4/rD Ola O In D: a V v <br /> Turn Around Time: 10 Day 5 Day 48 Hr. 4 Hr.1 Other I a I a =� a s o a '-Q Q y a o o v o o v o °a <br /> xa =a a_ . a �a °a Ea a v �„ 0y C E <br /> Sample ID Lob ID Date Time Matrix Preserv. w w 0 w .w �w 0 w o w o T u o a o u o x v <br /> �.. �.. �o a.. a.. >.. tn.. 1-v t-x UI- tel- wr <br /> 1 <br /> SPECIAL INSTRUCTIONS / COMMENTS: _ RELINQUISHED 8Y (Sampler): RELINQUISHED di': RELINUI ° Y': SAMPLL RI'CLIPI <br /> 1 L1 r4 J Total No. Containers <br /> (Signature) TI a (Slgnalure) (Tine) (Signature) (Time) <br /> C),'zk2 C-DD h <br /> 7-4 k- T ^ � (Prin�l\d Nom (0 e) (Printed Name (Date) (Printed Name) (Dale) __-_- <br /> {l.. Head Space <br /> A (Company) (Co pony) (Company) <br /> _.Y_. PJ <br /> RECEIVED BY: RECEIVED BY: EIVED� oratory}:f <br /> C,( Recd Good-Cond/Cold <br /> (Signature) (Time) (Signature) �(T (Slgnolu ) (Time) Y N <br /> (Prinled Nyna (Dale) (Printed Name) (Dale) (Printed Name) ( a ) Conforms to Record <br /> (Company) (Company) (Compony) Sit Y N <br />