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General COC 1 rk Order# <br /> McCAMPBELL ANALYTICAL, INC. F CUSTODY RECORD <br /> \^ 1534 Willow Pass Rd. Pittsburg,Ca.94565-1701 urn Around Tim 2 Day Rush 3 Day Rush STI7 Quote R <br /> V�/' _ \ Tclephonr.(877)252-9262/Fac(925)252-9269 J-Flag/MDI- ESL Cleanup Approved Bottle Order is <br /> \\�/ Nywmecampbell,com rnainO.mecampbell.com Delirery Format: Geo'fmckcr EDP I IPDFj 0 1 EDDI I WritcOn(DW)j I EQu15 <br /> Report To:TAMMY WOODS Bill To:TAMMY WOODS Analysis Requested <br /> Company:TERRACON CONSULTANTS INC <br /> Email:TKWOODS@TERRACON.COM <br /> r <br /> Alt Email: Tele:209-269-8586 Z <br /> CD <br /> Project Name/H:MACCHIA WINERY PROJECT NUMBER:NA1770004 U <br /> to <br /> Project Localion:7099 E.PELTIER ROAD,ACAMPO,CA PO 0 <LLI <br /> d <br /> Sampler Signature: W <br /> SAMPLE ID Sampling d <br /> Matrix Preservative F— <br /> O <br /> Location/Field Point Date I Time m <br /> Z � <br /> W1 1-26-17 9:00 AM 1 WATER N/A <br /> W2 (1 of 2) 1-26-17 9:04 AM 1 WATER N/A <br /> W2(2 of 2) 1-26-17 9:05 AM 1 WATER N/A X <br /> VIGN� <br /> EL— <br /> MAI elicits MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may wase immediate harm or serious Innate health endangermen as a malt of brief,gloved,open air,sample handling by\IAI staff <br /> Non-disclosure,itamrs an immediate 5250 surcharge and the client is subject to full legal liability for ham sufTemd.Thank you for your understanding;and for allowing to to work safely. <br /> •If metals are requested for water samples and the water type(Matrix)is not specified on the chain of custody,MAI will default to metals by E200.8. �Comments/Instructions <br /> Please provide an adequate volume of sample.If volume is not sufficient for a MS/MSD a LCS/LCSD will be prepared in its place and noted in the report. _t •1>\NA� , rs- P`e <br /> Relinquished By/Company Name Dale Time Received By/Company Name Date Time <br /> TAMMY WOODS/TERRACON I 1-26-17 1 9:17AM ),(fL CC:Uti-1 (r✓ '2L(/ Gq• IS <br /> PIM \1 2w 14CE <br /> Matrix Code.DW=Drinking Water,GW=Ground Water,WW=Waste Water,SW=Seawater,S=Soil,SL=Sludge,A=Air,WP=Wipe,O=Other <br /> Preservative Code: 1=40C 2=HCI 3=H,SO, 4=HNOa 5=NaOH 6=ZnOAc/NaOi-1 7=None Temp °C Initials <br /> Page_of <br /> Page 9 of 10 <br />