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Cal ciente Environmental Laboratories, Inc. CHAIN OF CUSTODY RECORD <br /> E BOCaI Laboratory Ni Service Center -/ <br /> L GM LlnegM Wey 5060 Comes l Cii Suite H Date <br /> GeNen GIOve,CA 82841-1427 Concond,CA 94520-95TT <br /> (]U)895.5s9L (925)609-9024 P.O. <br /> IABOR/QORY CLIENT' CLIENT PROJECT NAME I NUMBER: P.O.NO.: <br /> rw 06e <br /> ADDRESS'. - q OO <br /> J (, ]� W 'Z- PROJECTCONTACT: / ,f WBUSEONLY ISI <br /> CITY / STATE 31P �Cegl/NI F(/(/i Vp'/'u A- ID n b 9 ® ISI <br /> TElI-rU/tiG E-MAIL: (� 8RF�MIN(AC COELT LOG CODE COOLER RECEIPT w �=ti <br /> ' 1-f-243-- 4l N(/ ss�n 2ffw eYA"' r'¢e/[. M ❑❑❑❑ TEMP= °C <br /> TURNAROUND TIME: REQUESTED ANALYSES <br /> E]SAME DAY E)24 HR ❑40HR ❑72 HR ❑5DAYS ❑10 DAYS <br /> SPECIAL REQUIREMENTS(ADDITIONAL COSTS MAYAPPLY) <br /> ❑RWOCB REPORTING FORMS ❑WELT EDE ❑ Y$ m <br /> ' SPECIAL INSTRUCTIONS: U a6 <br /> PLEASE USE S(rrIOAFD-tY;T x m n `e <br /> A O p< <br /> ' o _ " <br /> Ue FIELD POINT NAME SAMPLING Na. -� w Q }y5 m SCS U Z <br /> uBa SAMPLE ID (FOR COELT EDE) uAmw OF t z d Lu O 0 > 57 v z ary. Y <br /> ONLY DATE TIME coxT. H m > > 1`u m a o_ O_ r V <br /> 6EL- I - 0r5 /o-//ro q:lp Sq111 I-Saal xl x )( <br /> ' 2 Ise L� 1 - S.D 1 10:%4- <br /> tie a_- I - .S o:yDX <br /> 9-S loss )( <br /> L 6EL- 2 - 5.0 ova I I X �( <br /> 6e - y -q.5' nV.)o X <br /> ' R 61 3 - 0.75 vto <br /> LTL' 3 - 7.0 /1:y0 X X <br /> Relinquished by:(Signature) Rev by:( naturelAMliation) Date: Tim m <br /> ' <br /> Ralinqubhatl by:(Signature) Re ivd or(SlgnatunEA"isation) Datano is <br /> Tiamte: gp <br /> Relinquished byGignature) Race.by:(..,loon,.....I..n, Date: Tan.: re0 <br /> O� <br /> aA <br /> m <br /> ' DISTRIBUTION:Vvh9e Noth finalt2ot.Green and YNkwM Client Po1N2 nl. OSRestatedPkaze note that pages 1 an0 2 of 2 of our TlCeera pinbdon OM reverse side Oi@e Breen and Velkw cod.respetliveN. <br /> C Cal4cience Environmental Laboratories, Inc. CHAIN OF CUSTODY RECORD <br /> SOCal lebpnlpry 11 111 1 Service Center Date <br /> ]140 Lkcpin Way 5063 COmmmdal Cimk,SUN.H to I i I Zoe? <br /> ' Gartlan Grove,CA 92841-1427 Coni CA 9452055]T — <br /> Gold 8955194 Con 689.9023 Page of <br /> LABORATORY CLIENT: CLIENT PROJECT NAME I NUMBER: P.O.NO.: <br /> &C"AFIG (00402 <br /> ADDREss. M <br /> GF D3S - 30zs <br /> 3 N uJ 4 Z PROJECT CONTACT: <br /> ^p IAB USE ONLY <br /> ' CITY -AS_TATE /ZIP F`T/f� Geta � ® -® ® ® al <br /> I t ``� b S4M�,LQR(S):'P61NT]_ COELT LOG CODE COOLER RECEIPT <br /> TEL - E-MAIL l .GJ'�' �Jl�fFlTl S h P'� ❑❑❑❑ TEMP= °C <br /> TDBxA OUND nMe. REQUESTED ANALYSES <br /> ❑SAME DAY ❑21 HR ❑4B TS ❑72 HR ❑S DAYS ❑IO DAYS <br /> ' <br /> SPECIALREQUIREMENTS <br /> REPORTING <br /> COSTS MAY EDD gg m <br /> ❑RWOCB REPORTING FORMS ❑COELT EDF ❑ C} <br /> SPECIA1.INSTRUCTIONS' <br /> �LE(ISC•- IISCtEKIA1 e m p r <br /> m <br /> w m o g b t <br /> W FIELD POINT.WME SAMPDNG N0. x $ u y <br /> USE $AMPLE D MOTRIX OF t Z Z FW L> ti y( 2Q (OJ v <br /> ONLY (FOR COELT EDF) DATE "M CONI. ti F H m W N d 4 a 29 > ti <br /> b /V/"/,v 13:of sei f- <br /> !'Lg-S.D 1 3%3tfi- <br /> IT <br /> ' 1 L-S-O-S I3:3o X <br /> I 15EL-5-5'-0 <br /> ' EL-6 -0.S <br /> JL Ise L-B-S.o <br /> Iq 159L-6 -S' lv:v <br /> 10 8g-L-wilwilLI,q oed3 <br /> Relinquished by:(Signature) 0.ete' m <br /> ( nalurelAMlialion) Dele: S-S S <br /> ftelinquNbetl by:(Sgnelure) Receiv :(SignaturNAMlkiipn) Data G Tm.is sl0 <br /> ' Relinquishetl by:(Signature) Reuived by:(SigmturelAlfiliatlon) Dale: Tanen v O_ <br /> �A <br /> DISTRIBUTION:Wfiae wiO isal report.Green and YessaTo 011enl. OSIOIPo]Ressi <br /> Please note Mat pages I and 2 of 2 ofaur T/ are ported On Me reverse side ofthe green and Yellow mples recpeLTNely. <br />