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Chain-of-Custody Record and Analytic IL11str, uctions Page of B 00078 <br /> . . ,. <br /> M-�r � <br /> ults and invoices to: <br /> t;Id Log Book#(COC#)__ y/ Release# <br /> t I,LNL Acct. # /3 (,O Co <br /> (please fill in and circle) ORRIJ� <br /> Sampling Request# <br /> Data Management Team L-633-1l.' :analytical Laboratory Name L::::-14 <br /> vermore National Laboratory analytical Laboratory Log# <br /> 8, Livermore, CA 94550 <br /> � ;ray x .x� <br /> Also Fax copies to: Fax# <br /> Analysis &Turnaround Additional Instructions to Lab <br /> _ Re uired 1 <br /> Project Name: (C a <br /> Sampled By :—Pp o C C Sampler's Employer: <br /> Sample Sample Matrix/Type 2 Grid/ r <br /> #of Study <br /> Identification Date/Time Container/Type 3 Cont. Area Remarks <br /> Si UXU.re Companv Time Date <br /> Relinquished — 1. N=normal turnaround, F= I-week turnaround <br /> R=24-hour turnaround,H=Hold do not analyze unless requested <br /> Received by � , <br /> 2. Sample Matrix Codes:See list on back of pink copy <br /> Relinquished by ~� 3. Container type codes: V=VOA Bottle,P=Plastic Bottle, <br /> Received by -- G=Glass Bottle,T=Brass Tube, <br /> _J B=Bag,S=Stainless Steel Tube, <br /> Relinquished by O=Other(specify under remarks) <br /> Received by Internal Use Onl <br /> CC: <br /> White Laboratory return to ORAD " i <br /> Revision 3.3 y Yellow Analytical Lab Pink:Sampler leaves with ORAD <br /> 29 Oct.93 ORAD Attn.Data Management Team L-633 y Att ORA 1)Data Management Team L-633 <br />