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i <br /> 4080 PIKE LANE, SUI FEC1.J rrarr,r-Vl--�.u.�+vu r nr�.wyu b U IJ 9 <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> tN1AlN1Al <br /> 0 TS <br /> (510) 685-7852 <br /> YkRON <br /> NZORA110911s. INC. a,, F! f 1i,..S. '•,;e 3'++ 'f ' <br /> (800) 423-7143 � "I � �r�.i.r�.:.._ • i <br />,ompany Name: Phone#: <br /> GAFAX#: ❑ a ❑ <br />;. any Address: Site location: M 0 ❑ ❑ ❑ o L) ❑ <br /> Con (&a <br /> project Manager: Client Project ID: (#)b7.aZD3Z$3-��OSO LO <br /> ° _� r r 0 Q <br /> x ❑ r~ ¢ <br /> NAME L 1 M � ❑ 0 ❑ ? z z ❑ : ❑ ❑ <br /> attest that the proper field sampling Sampler Name(Print): # a o ❑ A ❑ 0 0 -j 'M `�° U N a <br /> )rocedures were used during the colleclto ❑ p N ❑ ❑ a C o ❑ a u, © a <br /> )f these samples. '� ❑1 F „ o $ ❑ �" �, ❑ a oa ._ ❑ �- <br /> Method 1. a H c3 - 'n m a Co o ❑ a 0 ❑ <br /> Matrix Preserved Sampling n c� LL <br /> a ❑ o w as aa.. ❑ ❑ H ❑ Q p <br /> Field GTEL ° W W a. a. � ° ro ° <br /> o d _ o c6 ❑ ❑ ❑ a a ❑ °' y N 5 <br /> Sample Lab # o w a o _ <br /> IQ Lab use only) v �_ W _ o w w m a a a ¢ a a a F' a <br /> pp >. a. — a A a a. a n. 0. a a n_ <br /> rA Q N 0 x 2 — O t3 F m m x x O Il W W W W W W W W W N W U J O U <br /> W ' <br /> `1 <br /> i <br /> W DIM I <br /> TAT, pectal Handling SPECIAL DETECTION LIMITS REMARKS <br /> Priority(24 hr) ❑ GTEL Contact <br /> Expedited(48 hr) ❑ Quote/Contract N <br /> T Business Days ❑ Confirmation# <br /> SPECIAL REPORTING REQUIREMENTS Lab Use Only Lai# Storage Location: <br /> Other PON <br /> Business Das ❑ <br /> QA I OC LEVEL <br /> BLUE❑ CLP❑ OT ER FAX❑ Work Order# <br /> a'nqui hed by Sampler: Dat Time Received by: <br /> R <br /> CUSTODY Rel' quishecl y: to Time Received by: <br /> RECORD Relinquished by: Date Time Re I d by Laboratory: <br /> ev.Bret _ Waybill # <br />