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3050 Industrial Blvd <br /> W <br /> a I lace e e 1r..f h I West Sacramento,CA 95691 <br /> T _ _ Tel:916.372.1434 Lab Na/ ' <br /> ✓ (. . O Paye of <br /> e s J " c Fax:916.372.2565 <br /> Pro'ect conta t Hardcopy or PDF Tel: California EDF Report? El yds [� rlo Chain-of-Custody Record and Analysis Request <br /> c rtc 15 <br /> Company l Address: Re�ammeoeea om ooe maae.cory acompiete this se.doa: t.. AOeIySIS Request Q <br /> ampling ompany Lag code: H <br /> see above 1ZHr <br /> Phone No.: Fax No.: Global ID: o U <br /> 24 Hr <br /> Project Number: P.O.No.: EDF Deliverable To(Email Address): 0 5 O r <br /> 5279.03 1 1 m 48Hr O <br /> Project Name: Sampler w Q y <br /> Turner Road Vintners Signature: w y �` 72 Hr <br /> Project Address: barnpling on 3iner I Preservative Matrix O <br /> V <br /> WK <br /> Lodl ¢ 5 1 c �0 u. <br /> 0 w > 0 <br /> o Ew w w J zm o dW d Va <br /> 2OW <br /> K <br /> ' ' oSample 2z <br /> Lao W o Designation Date Time c ¢ _ n " <br /> z m <br /> C7 ul <br /> M W 1 Z/N/ 3Zr d I I x x I I I x x x x 5 Day <br /> MW2 L4 05- x x x x x x 5Day <br /> MW3 IIzV x x x x x x 5Day <br /> MW4 ? 15— x x x x x x 5Day <br /> MW5 x x x x x x 5Day <br /> 1 <br /> Relinquished by: Date Time Received by: Remarks: <br /> y r ``lw'l liZ <br /> Relinquished by. Date Time Received by: <br /> Relinquished by: Date Time Received rary: BIII to: <br /> I I I I I I i I I I I I 1 I I f <br />