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4080 PIKE LANE,SUITE c HAIN-OF-CUSTODY RECORD <br /> CONCORD,CA 94520 • 4'3 017 9 <br /> 510 685-7852 AND ANALYSIS REQUEST <br /> IGTEL <br /> ;.'. 800) 423.7143 <br /> r r <br /> Company Name: Phone H:(S 6 7 11-7 .3 P 7 <br /> Z FAX C. p ❑ � ❑ <br /> Company Address: 1 b S ) u 1 y,t�5lte Location: STI L- m m = ❑ <br /> GUv �vr 1 [ —�Cr r �+ u I (4�`.1 'r� �`�y p ❑ ❑ a <br /> ❑ "' w a ❑ ❑ ❑ <br /> Project Manager: S 1 �„ GS �� Client Project ID: (�),2 07p 7 ❑ � � � � � ❑ � N <br /> 1p <br /> I attest that the proper field sampling Sampler Name(Print}: ❑ in " Z. p ❑ : E ❑ ❑ ¢ <br /> procedures were used during the v 0 ❑ a a 9 w v ❑ <br /> collection of these samples. t rL �'` �`` I ❑ a Q a m p a N d `a <br /> Method ❑ m `� a m m o ❑ o ❑ y <br /> rn Matrix Sampling �, Q a ❑ a a a � ❑ ❑ _o o > g <br /> Field GTEL. w Preserved 0 z ❑ ❑ w w i a y ❑ LLI <br /> ❑ <br /> Sample Lab 1# a w i N m q q c� d �; ❑ ❑ o ❑ <br /> % .2 o m m -'D' s <br /> ID {/Lab Use w wQ w- w w x�x 2f 2S o +`� w w o a �' '2 <br /> O S W fn a a a s t t Q F' -.i a '° <br /> Only O O a J Q U 2 n 4 F % i. O 4 4 0. n. d d & M U d C m <br /> . 3 rn a rn a 0 x x x _ �, o o ~m m x x 0 IL W W W W w w w w W r W U J o v <br /> ' t`��r ;i irk :':r. 'Y.- rf:. .�s�p�pyy''f {r'nf :l s. <br /> V1 -J - tj j.! t , <br /> ") I .�? :iq:i r4:4+ }' i :"$ ; ;� a x4` .�` late: }�r:; `� •.� :t.,: � �:.� a { fF} :? ! A � } <br /> ..-3 L1 r' 4 lit, <br /> f ,.1,� F r <br /> Al li;!{r" ~ a�E ;K:j � � .# `I;' ;i� 1G;' <br /> �r•,L Fr'.:ri�� ' + " 1,iw Ii51r` ••43 ; ir i �i yyT '.rri01'' :jTT `TAT Speclal Handling SPECIAL DETECTION LIMITS REMARKS: <br /> Priorlty(24 hr) ❑ GTEL Contact <br /> Expedited(49 hr) CI Ouole/Contract N <br /> 7 Business Days ❑ <br /> Confirmation N <br /> Other <br /> Business Days ❑ P.O. N SPECIAL REPORTING REOUIREMENTS Lab Use Only Lot N; Storage Location <br /> QA/QC Level <br /> Clue O CLP p Other❑ FAX❑ Werk Oder N: <br /> nefln%phed by Sampler. Date Time . Received by: <br /> CUSTODY 7- 7 1 12: <br /> R i uishedby: ate / Time Received by: <br /> RECORD <br /> Relinquished by: Date ,Time Recaived by Laboratory: <br /> q - 30 Waybill N /. <br />