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4080 PIKE LANE, SUITE C, 49 F <br /> HAIN-OF-CUSTODY RECORD <br /> r r GUNCURU, CA g4520 ND ANALYSIS REQUEST <br /> 14#A ETAL (510) 685-7852 <br /> Rio "ANOR�TORIESN MC (800) 423-7143 <br /> , t <br /> Company Wme Phone# o f V 7 J - 23 -9 7 <br /> ❑ Cl <br /> 11,4c—• FAX# ❑ w v L3 <br /> Company Address Site location (104 c- r r fl; f•ti��a m ❑ _ ¢ ❑ <br /> `n Ll U U N ❑ o ❑ <br /> 41 LO <br /> Project Manager Client Project iD (#)©Z Zr�Q2 �� 3 (�G•�l ❑ W + 4 Q ❑ ¢ ❑ CU <br /> — a� 4l s ~ N <br /> CR - [n ¢ It <br /> �O ►M.1,5.5 s>~ { D� W C V�rt. NAME s 00 o ❑ N ❑ z z ❑ E ❑ <br /> I attest that the proper field sam tng Sampler Name(Print) d y 63- <br /> m ❑ S ❑ o J Ll N <br /> procedures were used during the collection 'n/ �, a m a a Wo <br /> N El C3o <br /> I` L'4[, C' lh Vl fi. [_I v3 CD -0 0 0 o L) o o 1 rl N C7 <br /> of these samples �, 0 4 N N <br /> �n N v Cti d Q U r <br /> y Matrix Method Sampling m `� n a a a ❑ ❑ °co co Z5 ELL <br /> l <br /> Preserved = a ❑ o W 2 J J co a <br /> Field GTEL h Clrz <br /> Sample Lab # o i` NC1 ro CM CD <br /> �° " T o o o N N m y <br /> �3 v v tC a ci +a co co cfl is O C _ <br /> ID (Lab use on w ❑ ❑ W W �-w w 4CtJ <br /> tpl7 Q y a O x T 2 U O'?O m m = 2 O a W W w w W W w w W IU- W U O C7 <br /> -161-6 01 X_ x <br /> mU to 3 ' <br /> M p 3 .3 <br /> M w d 3 <br /> Vh 0S j' 13 3'DO <br /> V%I\L-1 7- p 3 3 io <br /> 3� 0 <br /> ' lin•� � Q 3 �,3° <br /> w► 5 <br /> -TAT -� Special Handhng SPECIAL DETECTION LIMITS R�13C`�Zo- <br /> Priority(24 hr) ❑ GTEL Contact <br /> Expedited(48 hr) ❑ Quote/Contract# b S ; l Y Zs v � <br /> 7 Business Days ❑ Confirmation# <br /> Other PO# SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> Business Das ❑ 0 <br /> QA 1 QC LEVEL �f <br /> BLUE❑ CLP❑ OTHER FAX❑ Work Order# ©� ! <br /> zit'u.�'5'e <br /> d by Sampler tAA _ Date Time Received by <br /> CUSTODY ReII ursh by , P Date Time Received by <br /> L'0L9 is -�'I�� 11 X15 <br /> RECORDRelinquished by Date Time LRecewed by aboratory <br /> r <br /> ..O <br /> Rev 7191 OIL� f <br />