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2795 2nd Street, Suite 300 <br /> JrfVT7Co4I_ <br /> �� Davis,CA 95616 <br /> Lab: 530.297.4800 j <br /> Lac Fax: 530.297.4808 Lab No. —7 Page of t <br /> Project Contact(Hardcopy or PDF To): California EDF Report? ❑ Yes ❑No <br /> :v k n -(�f f ,� Chain-of-Custody Record and Analysis Request <br /> Company/Address: Recommended but not. to complete this section: <br /> Sampling Company Log Code: FF- <br /> C) <br /> IGv �' Analysis Request Phone No: FAX No.: Global ID: m X3qZ i�3V `Yl 3 �Z96�5 i- a �,- o- 7 C� U-d-Z. o o LULU <br /> Project Number: P.O. No: EDF Deliverable To(Email Address): 2 ? m o T <br /> 1G � B . / b ai � NX (-!�i-)a <br /> Project Name: o N M M N CO 3 0 <br /> 1 1 Sampler Signature: CO m m - a <br /> � LSt ri'eNnp J w n w m CU Co �s w w <br /> Project Address: M ; P- = x ( o `o <br /> Sampling Container Preservative Matrix _ o a a S _ -0 N = cu <br /> y N = a) J <br /> Q m 00 <br /> 0 .�... \ L <br /> Q N 2 �_ O 4] "�' a; d CU m _ C <br /> (r CL D N C C C N O = CV L LL <br /> t� W W N N M N W N W U N N <br /> E W O Z H J X m co C7 m m T >, w .m <br /> Sample DLO <br /> esi nation _ o <br /> P Date Time v n i = U z m m 0 0 0 0 0 w > J N <br /> w /D /o o <br /> Mw3 <br /> ''V` 1'`1 � , P <br /> M w � 41 <br /> Relinquished by: Date Time Received by: Remarks: <br /> 21 A lab <br /> Relinquished by: Date Time Received by: <br /> Relinquished by: Date ;mLeeceiL)dby��g�Lboratory.: �[ Bill to: <br /> ------------ <br /> Distribution:\ Lab, Yellow-File,Pink-Oris <br /> ginator f ( /coc 121001.fh9 <br />