Laserfiche WebLink
CHAIN OF CUSTODY I LABORAr1,*Y ANALYSIS REQUEST FORM <br /> (W 1433 Nurlb Market tlnulcvartl,Sats atnttultu,CA 95814 SLIVILe Ii9L(l1tt5l No PO Number NIA Page I of I <br /> aEMCOn (916)928-31411) IMAX (916)928-3341 Lab 1'er1'orrllarlee <br /> ProjeName Telcherl Strrtktull 11n,t1 sts itac tested <br /> at <br /> Project Number UF90-0021104 <br /> Project Manager Matt 1'ul ner �a1S$fib <br /> v <br /> Company EMCON <br /> Address 1433 North Markel Boulevard u <br /> Socralut.111111,CA 95834 <br /> Phone (916)928-3100 ° <br /> FAX (916)928- 4l p L) <br /> Sampler's Signature _ _ __—_ _ __ __— __ S <br /> z � REMARKS <br /> Sample alllp e 8 Container <br /> I D Date Tune I D Matrix NP Preservations <br /> Influent `) 2 S 1T+'— ti5t,%Ackou vapor <br /> Effluent 17-40 CiSaVgol vapor 1 I <br /> I A— <br /> SI 1.IN(�U15111 U I{Y KI'l 1 I U I HI I IN1,1tASIII 1)BY NI i l {Vt i{11Y I IIHNAHt1UN1) HFPI)ttr R!QUIHEMhNrS <br /> K L� / Hi (till lt!'1111 N 1 S X 1 Routine Report <br /> Sngnalurc <br /> „n nul� Slgualul� Slgn etult 14 hr 49 w 5 ayy t! Report(includes DUP,MS <br /> titxnJ uJ(`lU 15 wrnkmg days) MSD,as required,may be <br /> Printed Nam 'I tllll.tl Namey Prinict}Nall ll. I'1111lld Nan tL lhuvajk Vr+1+.i1 Pretinunwy Nelah, charged s5 samples) <br /> � `m �`�r t+C �Y�4� ��ta,1 Nv�i&I AX i'nlmumry ResuhIII Data Validation Report <br /> s <br /> Bryn 1 1fl 1► }lrpl ftrlu Nnt+�slcJ N�rxnt Isvc (includes All Raw Data) <br /> 91Iz1530 01 '1; C1S C1'00 A,tv RwDce <br /> Drtc/Piinc w1uUS"ri' U UJI linContainer Types t_ DAILA II11L Wtdrnne IMDIs/P Container <br /> rTypes <br /> Key <br /> REI INQUI5HPD III HI 0IVI.1)111 %pruJI imlrutliuu+llurnments <br /> 40 inl VOA 1 <br /> 125 mi LPE 2 <br /> Signature Signature S00 m}LPE 3 <br /> 1 liter HDPE 4 <br /> Printed Name PRuit.d Nance <br /> 500 m!glass 5 <br /> I liter glass 6 <br /> Finn t Irin 2X6 s!s ring 7 <br /> Tedlar Bag_ 8 <br /> Datil ime DJtclrune <br />