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2795 2nd Street, Suite 300 <br /> /FF Davis,CA 95616 <br /> Lab: 530.297.4800 3�2� Page�s <br /> ANALYT/CAL <br /> LLC Fax: 530.297.4808 Lab No of <br /> Project Contact(Hardcopy or PDF To): California EDF Report? L_I Yes ❑No <br /> � Chain-of-Custody Record and Analysis Request <br /> mpany/A ress: Wdf�sY+t!S Reoo wrmded but notmwid0mytoomwisbVisseclim- <br /> Sampling Company Log Code: Analysis Request � <br /> G � � <br /> Phone No.::� FAX No.: Global ID: o <br /> o o N w <br /> C"I CN <br /> Project Number: P.O. No: EDF Deliverable Ta(Email Address): 2 S S Co C3 <br /> Fa 0° u� W w Co x ` <br /> N i— <br /> e <br /> m a- H 0 <br /> Project Name: j� Sampler •gnature: $ o w m o ,� w o <br /> r °D aro (7 C7 o N U �' c <br /> ID _ 2 2 Co p <br /> Project Address: Sam lin ontainer Preservative Matrix o u, N <br /> �4�7� mLZ co <br /> o m d m f C <br /> M LL <br /> //l o w W n 0 m iD ami m I co r � _ �+ <br /> %'T > > M w w t— m m (� rn w m � T -, <br /> w p w z a J x si si x x v is <br /> Sample Designation Date Time v i = i z m m a o 0 0 0 w > J <br /> G <br /> 106 — 30 l � <br /> C, <br /> Relinquished by: Dat Time Received by: Remarks: <br /> rni 7db . Dat Time Received b <br /> elinquish by: Date Time Received by Laboratory: Bill to: <br /> Distribution: White-Lab, Pink-Originator Fortes/coc 121001.fh9 <br />