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General COC MAI Work Order 4 ! O <br /> ® McCAMPBELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> O1534 Willow Pass Rd.Pittsburg,Ca.94565-1701 Tum Around Time:I Day Rtishi 11 Day Rushl 13 Day Rushl, I STD Quotet, <br /> WO Telephone:(877)252-9262/Fax:(925)252-9269 J-Ilag/MDL I ESLI. I Cleanup Approved Bottle Order# <br /> www.mccamyl_Iacl Lcom main(a�mccamnbell.com Delivery Format: PDh GeoTmcker FDFJ I EDDI I SSrnle Dn(DW) I EQuIS <br /> Report To: 'Q I I I l/ k I'on V Bill To: [ CQ111 QJ Y-1 CII)U-1- Analysis Requested <br /> Company: I-)0 1'6l UCIX -E I) 1 IL l r 11��' 111( it b = <br /> E-mail: C I'NCM' 1 G- 7C,f1'C(I�, IX CC)hn c _ 9 <br /> Alt Email: j�c llQ I fLLrC C1FCI ICC'IX (� cle: ° ° a _ <br /> Project Name:Ct,qSLI-)r3C 11'1, N1-S Project it: ku <br /> Project Location:lgj,l0 PDCtk 1)01' C ll))Cf) Il + + = _ <br /> _ a a 8 e <br /> Sampler Signature: `�2� v/ m° E a E- _ z <br /> SAMPLE ID Sampling j5 <br /> Matrix Preservative Q 9 V <br /> Location/Field Point Date Time <br /> u ca 5 9 <br /> 1711511 VUcI tD.SO 2— <br /> MAI <br /> MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause immediate harm or sennas futum health endangerment as a result of brief.gl-cd,open air,simple handling by MAI son. <br /> N—clisclosme incurs an inunedime 5250 surcharge and dw client is subject to full legal liability for harm sun'cred.Thank you for your understanding and for allowing us 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 the volume is not sufficient for a MS/MSD a LCSILCSD will be prepared in its place and noted in the report. <br /> Jjclinquished By/Company Name I Date I rime ed By/Company Name Date I Time <br /> rti- c.� ilIN�l �•. 1Vlelfie I d <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=4°C 2=HCI 3=H,SO4 4=I11N01 5=NaOH 6=ZnOAC/NaOH 7=None Temp 75,` °C Initial <br /> �t <br /> Page_of <br /> Page 7 ol'8 <br />