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41 a <br /> 4080 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD 41986 <br /> IGTEL CONCORD, CA 94520 TAND ANALYSIS REQUEST <br /> (510) 685 7852 <br /> (800) 423 7143 ilkI <br /> t <br /> Company Name Phone N (916) 372-4700 <br /> Fluor Daniel GTi FAX fJ 916 372-8781 ❑ ❑ a ❑ <br /> Company Addressl 401 Halyard Dr. Site Location m m p Q � o] W <br /> Ste 140, W Sacramento, CA 95691 Sal � � r_ U) El ❑ d It t , <br /> 17]�o N u a L) <br /> Project Manager Client Project ID (0) Cl � � ± * n ❑ -J <br /> Store # ❑ ❑ rn m m i o ~ <br /> Jaf Au hterlonie STHL 020700 ca U. o ❑ ❑ z z ❑ ? z Cl F1 CE <br /> 1 attest that the proper fiold sampling Sampler Name(Pant <br /> o ❑ yr ❑ ❑ H cn o <br /> a 0 o ^; 00 C� O J -J p v I F <br /> CA <br /> procedures were used during the Qom] c ❑ o > N ❑ ❑ v d �a- N ❑ a rrn r- <br /> o <br /> collection of those samples - +'�" 3 "t 2 n. o 0 N a a m a © a <br /> ❑ W m Y U `� O Q N N ❑ d Q 2' t� n <br /> Method o g o d on a 0. a a o m m o ❑ 7 `a_ U <br /> Matrix Sampling No � � a m ❑ W a M o ❑ ❑ , ❑ � J S L] 4 <br /> a Preserved co = W m 1 7 ❑ W W m a a W m y m ❑ D [ i <br /> Fteiti GTEL z ❑ y m g _ ❑ ❑ ❑ a a ❑ R N 0 -- <br /> Sample Lab t'1 W �_ t7 CD N N o " N Y <br /> ID (Lab Use 0 J o 0 W _ S o aw Wr w w w p C �o 0 0. V M o <br /> 1 J I {n d Q d d d Q <br /> only U d p Q ¢ } V z rn w ria d �_ h t1 O a. rl 0. 4 a R a d U d d m o <br /> y r rn d rn a 0 t S z U SUW O� ❑ r- m m S T O 7- W W W W W W W W W F W U J Q U <br /> /� -5 bZ- 3 ros <br /> �1Vu fa -- <br /> MV _ D D 3 o <br /> t E <br /> r <br /> J <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> Priority(24 hr) fJ GTEL Contact <br /> i <br /> Expedited(48 hr) i I Ouole/Contract N <br /> 7 Busmeas Days I I Confirmation N ; <br /> 01heiV es SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot N (t p e Storage Location <br /> Business Days [ ):PO N <br /> d <br /> QA/QC Level C <br /> Blue IJ GLP❑ Other 11 FAX Work Order N <br /> Relinquished p -r Date Time RqNlvcd by <br /> °9 <br /> CUSTODY > <br /> RECORD Relu quashed by � datee Time - Received by - <br /> 9'_p • s5 <br /> Relinquished by Q Date pTime Received b Labor ato / -7 <br /> WaybillN y 6rya-17 Z- _ � <br />