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J <br /> 4080 PIKE LANE, SUITE C <br /> , <br /> ! AND ANAL YSIS REQUES t <br /> JIGTOL 3 CHAIN-OF-CUSTODY RECORDCONCORD, CA 94520 S <br /> EHVIgAOHIAEESNTAL 685-7852 <br /> LAEORTORIIHC, ( 10 <br /> (84 O <br /> 423-7143 <br /> am Name: � <br /> //� �11l Phone N: <br /> �� FAX N: ! ❑ �' ❑ <br /> )mpany Address: Sit i cation: ❑ ` <br /> oject Manage : :? Client Project ID: (N) ❑ � '�' G a Cl i <br /> ❑ 3 �, <br /> t111 J t L (( i��l L E NAME ULD 7O I— c� cn cn m ¢ r— Ev ro <br /> Itest that the proper field sampi' Sampler Name (Prin U 7D Mm ❑ ❑ © z z 0 0 ❑ ti Cr <br /> )cedures were used during the colieclion ❑ o �? ❑ ❑ 8 .q ❑_ H _ ❑ ❑ <br /> '/ / t a41 <br /> these Sam les. l C• j s C7 ' c, > Ev m '¢ Li. Ep sn v <br /> Q a m n- <br /> N Matrix M thod o d m ¢ ❑ N g ❑ Q <br /> Field m Preserved Sampling bo 8 0 o a o E� o co m <br /> GTEL c i w ❑ w ¢ ¢ o ❑ > S <br /> Sample Lab # Wp ❑ i ❑ ❑ w w m o ca ❑ a ❑ <br /> C U T cv en a m ao Q (L i.n ' y ❑ ro 4t <br /> ID (Lab use only) U It¢f l7 � o M c`o `� "' ❑ ❑ ❑ r1 IX ❑ g m ;v N w <br /> F- p O W w ¢- cA v u a o o nl ob7 v o � u .� <br /> 7 <br /> Ct J Q H U 2 w UlU W W O O C a u'} ,D to �D C4 CQX d t7 <br /> (n d rn rL O z = 2 U Oy �" ?'• 4 4. 4 0. Q Q Q d 0 ..0..r Q N <br /> h m m z z p +-- w w w w w w w w ui IV- 10.0 U f] U <br /> j 7 <br /> 4((J-4 <br /> '( V— t <br /> ' U <br /> ` A — I <br /> TAT Special Handling SPECIAL DETECTION LIMITS <br /> � `/ REMARKS <br /> ri (2ghr) ElGTEL Contact <br /> •TQited( 8 hr) ❑ Quote/Conlract N <br /> sines9 Days ❑ Conrlrmatlon M <br /> .rfin. 1 J Po'. SPECIAL REPORTING REQUIREMENTS <br /> ,;ggg pas ❑ Lab Use Only Lot N Storage Location: <br /> QA l QC LEVEL <br /> ❑ CLP❑ FR, t <br /> FAX❑ Work Order N <br /> Relinqui by Sampler: % ate Time- Received by- <br /> he STa D r hed Dat Time Receitj.ved by: } <br /> !C CO�1 D Relinquished by: I dl t! <br /> jDate Time Received by Laboratory: <br /> Waybill # <br />