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I(IFF ANALYTICAL JSSL Chain Of Custody Record <br /> • <br /> Shell Project Manager to be invoiced INCIDENT NUMBER(SSE ONLY) J J <br /> 2795 Second Street,Suite 300 Q SCIENCE&ENGINEERIN Karen Petryna 9 8 9 9 6 1 8 4 DATE <br /> Davis,CA 95616 ❑TEa+nIaL 5ERVICE5 SAP or CRhIT NUMBER(TSICRMT) <br /> ��O PAGE <br /> (530)297-4800 (530)297-4808 tax ❑c K:T HDtISTO% <br /> SAMPLING COLWANY LOG CODE SITE ADDRESS(Straet and City) OLOBa IDMO <br /> Cambria Environmental Technology,Inc CETS 2575 Country Club Blvd Stockton CA NIA <br /> ADDRESS EDP DELIVERABLE TO(Re inner Pavy v O�sgn I -Lm NO E Ma,i COH5,11 aNr onraiEc*Nn <br /> 5904 Hollis Street,Suite A,Emeryville,CA 94608 <br /> PROJECTCONTACT IMr+KGPI r POP ReW mt NIA NIA N/A 245-0783 <br /> SAMPLERS NAME LAB USE ONLY <br /> Cynthia Vasko f��J ^ ' <br /> TELEPHONE FAX EMAIL rl /r/v 'V <br /> 510 420-3344 510 20 3394 cvasko®eatnbria my corn <br /> TURNAROUND TIME(BUSINESS DAYS) REQUESTED ANALYSIS <br /> ❑ 14 DAYS ❑ 5 DAYS❑ 72 HOURS❑ 48 HOU 24 HOUR LESS THAN 24 HOURS <br /> ❑ LA RWQCB REPORT FORMAT ❑ UST AGENCY op <br /> N z FIELD NOTES <br /> GC✓wtS MTBE CONFIRMATION HIGHEST HIGHEST per BORING ALL a v O <br /> SPECIAL INSTRUCTIONS OR NOTES CHECK BOX IF EDD IS N9I NEEDED . = ° m y ContalnerlPreservative <br /> m ] ca E m c or PID Readings <br /> —L,o F � ) f7 �, m r n tO in m or Laboratory Notes <br /> 10J1 < n m a $ c m C4 0 w a n <br /> pH reading(frekf) 6.pOIL3��4GrG�HJT /Q L1 r•P q e �rr 16 q w u <br /> a m U o <br /> Vo LU m h a v a m <br /> N m m *� W <br /> v 6,00UG,4iJowv -rn�To 4446,-Ta NAG � "' <br /> ao c = c = " i ' " `0 6 LI <br /> X w w oy c A tl � a Y c `a e c " A w TEMPERATURE ON RECEIPT C° <br /> LAB SAMPLING NO OF = w M m „ A (a 4 U IL a a a a w <br /> USE Field Sample Identification MATRIX corlT d x m o a 0 s m ro m a a m <br /> W&V DATE TIME m O w w w 7 r ? ] ] 7 ti- is <br /> INF / D AQ (a x z x How <br /> Al <br /> AQ ! x x x How <br /> —'MID 1- F7 !!11 <br /> MID 2 <br /> AQ (o x x x <br /> EFF AQ <br /> Aatn <br /> me <br /> ecelved by. Slg—) <br /> , <br /> Cate T,ne <br /> R b 9^xu ) R ivedW ISW ao,re) z <br /> re � � <br />