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4080 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD 72 6 0 9 <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> 685-7852 <br /> r 800)423-71143lFIGTEL <br /> Me <br /> Company Name Phone# <br /> 7II <br /> �� r <br /> ompany Address <br /> Site Location t70 { oo�Qdo I 1 I f U 7,71 <br /> U [ I i1 y <br /> � U a II l II <br /> Protect Manager <br /> Client Project ID (#) `i'1oa009 ❑ � N M �, �, ¢ r a <br /> RIC 1 V S ' ro <br /> m ° n n i] I I z z zl ° I I <br /> 1 attest that the proper field sampling Sampler Name(Print) 5 0. �I o '2 L} r 1 c I I i t I t CV <br /> o <br /> a co D J J q N U A <br /> procedures were used during the ion y n o N tl [ I cmi 1 a <br /> collection of these samples + o � a ' o N a I I a rn 11 n° n <br /> �p v n a <br /> Method IN 2S o v W a W W of Go °N° o i l 0 <br /> Matrix Sampling a` I I ° c o l t I I �, y I I a` N I I <br /> Preserved T N N r f 7 w ui m -a J co b <br /> Field GTEL z I I y d m I f 1 I { I I a 0. t l R m IN 2.1 <br /> Sample <br /> Sample Lab# lu �; o N X a d <br /> I� ab Use w b o w w�°, W W w x 5� c +n c� w is O d a d <br /> a , CY <br /> r ru q v 3 m a a a ¢ a a a a b <br /> only V a O s c> z W z� a >- r r r - a o a a 4 a a a a a U a a m o <br /> [� ! : 3 rn a rn a o x s = r m co x x O r w w u, w w w W w w r ue v O U <br /> -Tie)I— IX X -— - <br /> 2lit) n <br /> m 3 -- <br /> LL- <br /> MW - ID 05- <br /> iJ o 1 -- <br /> W1 1)A I I JMW — -- <br /> tr� <br /> -- pa - <br /> TAT Special Handling S ECTAL DETECTION LIMITS REMARKS ( f) Sp0 M 5 <br /> GTEL Contact }Q � t 1�2 \ �0 Q('t Ll <br /> Pnonty(24 hr) �} {� <br /> Expedited(48 hr} L7 Quote/Contract# ;S p �L?TIoq Q 4 Z�n <br /> 7 Business Days f] Confirmation <br /> Other SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# o Storage Locat n �IZ <br /> Business Days ❑ PO If <br /> QA/QC Level Work Order C 1100 2-5 L <br /> Blue❑ CLP O Other❑ AX❑ # <br /> nets ishe y S m e Date Time Received by <br /> CUSTODY Date <br /> R linqui ey Time Received by <br /> RECORD ��-I��IY .�r� <br /> Re inquishe b ! Date TiIt <br /> me R e'wed by Laboratory <br /> Wa belt# , r <br />