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Oh hem GJG <br /> 4080 Pike Lane CHAIN-OF-CUSTODY RECOR CUSTODY RECORD i 3j <br /> GTELConcord, CA 94520 800-544-3422(In CA) AND ANALYSIS REQUEST r( <br /> E N V I R O N MEN IAL 415-685-7852 800-423-7143(Outside CA) ANALYSIS REQUEST - <br /> 1A60RATORIrS INC <br /> Project Manager Phone#/-JA/57-6 7/"y;,f7 W ❑ W 0 0 m <br /> FAX# F/f=bS5 - 21 -B m o 0 ❑ ° <br /> Address 9�rzp Site location ❑ o <br /> Cv.I�,aratr 0 ❑ ❑ ❑ ❑ ❑ ❑ a ❑ N M - <br /> a S' 7 pori CG, GG a /�c., oG/YGr�uv� Ca m 0 N m E o + + i o = o a <br /> Project Number Project Name a ° � " <br /> G L -3Z-C)-1097 a www �Y� 3 CCOo ❑ ❑ a o O z Z m O ❑ <br /> O 6 O O � j� ❑ _� ❑ _e u ❑ ❑ C 3 4`1 <br /> I attest that the proper field sampling Sampler Name(Print) on ° <br /> procedures were used during the collection ❑ m - N �' °i e j <br /> of these samples G 1--t" 2-1 N NIQ _ ❑ ❑ ❑ ❑ C] .p 7 ?t N �' 0 -17 <br /> �' Matrix Method Sampling w o o m M �' N ° ❑ +CY J <br /> rFleldSource GTEL � p 9 d a of Lab# Z Preserved ❑ o Q 0 13 4 1 R � nSample (Lab use a w o ❑ - °° v +o b v> 01 = a m <br /> r N N 2 r• y 41 47 <br /> only) Z Lu o w r, 0 W w w w x m 5 d m m �n ca p a a p O �j > > > <br /> ❑ -� z O u7 w Z 2 t~ g w w = o :° a ¢ a a a a � a ai � v ar W <br /> U a 0 [[ � F U Z N V O h d w OL 2 0 o a o n a a a a V a t�i a o <br /> # cn a v0 O z z _ Z O h qa �m ►- a r W w w w w w w 1- W J U U q- C Cc Ir d <br /> i 1 t7 !S-o <br /> (2/a LG S 1- <br /> 1 <br /> - -�--- <br /> .� D< E Q E ... E <br /> w <br /> Yu w-3 - - --- 17, - - -- - - !s <br /> CIS <br /> r,w—b d 1b3 � <br /> SPECIAL HANDLING SPECIAL DETECTION LIMITS(Specify) REMARKS L <br /> m <br /> 24 HOURS ❑ E <br /> EXPEDITED 48 Hours ❑ <br /> SEVEN DAY ❑ <br /> OTHER (#) BUSINESS DAYS <br /> QA/QC CLP Level ❑ Blue Level ❑ SPECIAL REPORTING REQUIREMENTS Lab Use Only Storage Location Cr a <br /> FAX [3 (Specify) <br /> Lot# Work Order# <br /> a z z <br /> 0 <br />