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• <br /> KIFF 2795 2nd Street,Suite 300 <br /> Davis,CA 95616 <br /> Analytical ttc Lab 530 297 4800 SRG#I Lab No Page of L <br /> Fax 530 297 4802 <br /> Project Contact(Hardcopy PDF To) California EDF Report? Yes <br /> (�f Chain-of-Custody Record and Analysis Request <br /> Company/Addre Sampling Company Log Code Analysis Request TAT <br /> j a <br /> Phone# Fax# Global ID a <br /> � m m <br /> 02 12 hr <br /> Project# PO # EDF Deliverable To(Email Address) 1>1 m O <br /> 04 <br /> Protecl Name LY o co a 24 hr y <br /> Sampler Signalur $ a o N a L <br /> n W m a p <br /> L W O O d y N co <br /> Project Address Sam Itm Contain Preservative Matrix d co `� a co d <br /> P�7Ci mo m m '6 — a- w o 46 hr `o <br /> CC•� Q a ,� a J LL <br /> Al-1.1, N N w w 0 w Q C. <br /> U) <br /> Q W <br /> yrn w tm <br /> ❑co W 0. mm 6 O ad m 7 -a 0 21 T 72 h <br /> r m 0 z� 08O 0 a 2 <br /> ao <br /> w w X T m m <br /> p m m C7 rn co 03= <br /> Sample Designation tD aYUZ p — IT o0 <br /> Date TimeLu <br /> y > F <br /> 1Ski <br /> lao <br /> i <br /> LL I I <br /> Relinquished <br /> Remarks Date Time Received by Remarks <br /> 1 � <br /> Relinquished by Date Time Received by <br /> all 10 <br /> Relinquished by Date Time Received by Laboratory <br /> For Lab Use Only Sample Receipt <br /> 101305- yZO aj�� J Temp*C Initials Dale Vine Therm ID t! cooi�,+Presern <br /> ?C(� 7r Nl ( (VD 1 7.C1 es No <br /> Distnbulion While Lab Pink Originator <br /> Rev, 051805 <br />