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4080 PIKE LANE, SUITE C CHAIN-DF-CUSTODY RECORD <br /> IGTEL CONCORD, CA 94520 AND ANALYSIS REQUEST 40304 <br /> (510) 885 7852 <br /> (800) 423 7143 <br /> Company Name Phone# (`719) 3 71_V7 <br /> &0111A WGI r �Cc�h�' In'- FAX# ❑ <br /> Company Address IYoI 1)rq .r/ S.,rk1Y0 Site Location 'f SS 6raht jrhr/j� M z <br /> C] ¢ <br /> Nest Sacra C True CA d ❑ C <br /> Project Manager Client Project ID (#) # 0. <br /> 0 N g (3 ❑ <br /> O�tt7 651005' <br /> ❑ N <br /> 1 �f lutn1 <br /> t m ao " oa <br /> ❑STH T m ❑ z z m <br /> ❑711 I that the proper field sampling Sampler Name(Print) ❑ c ❑ <br /> m g E <br /> prdcedurns were used duruig the ❑ to ❑ o .J -J aU v <br /> JmC <br /> T❑ <br /> collection of rhes©samples �OrIC V1Czi (A O ❑ Qn © ❑ a ❑ a <br /> ° 0' 41 <br /> r'Method � ofn Matrix Sampling ❑ > 6 <br /> oGTEL Preserved 0 ❑ <br /> _J <br /> Field ❑ N Ix c <br /> N a ❑ ❑ <br /> OOOlO ¢ > O $ N N Xl ] Lab Use #w Lro 2No w wx cnn <br /> 3 U zn N.> i- LLI a a a a a 2 v 0only cc zir a nm¢ 0 <br /> V7 O_ 6 W, LU w w w w w w w I.- wOOz w w -1 opSampl? Lab # z , <br /> L r�r <br /> ` <br /> 0. <br /> 110, <br /> N � <br /> A � <br /> firLf N <br /> 1, "A �%� <br /> 3 <br /> i, y <br /> fn <br /> ILL I <br /> � I J/ � 3'3 •: I ,L "� , 3 J�` r,`: �:�i��. `' :�t � i 'f ?fix �° s�� I; <br /> '7 I lj Ito,r 7 1 1. <br /> ` <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS reJ�of <br /> Priority t24 hr) i i GTEL Contact <br /> ExPedaed 08 hr) i I Quote/Canlract a <br /> 7 Bucmecs D-,ys <br /> Other STA4)AkO Confirmation# <br /> Business Dzys PO 9 SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> QAIQC Level /69 <br /> -- <br /> Blue CLP a Other r l FAX❑ Work Order# <br /> Relinquished by Sampler ate T ReceiveQ by <br /> CUSTODY S <br /> Relinquished by 1110M Received by <br /> RECORD Time <br /> Relinquished by Dpalie "Time Received by Laboratory <br /> ll-'e,V5 0'90C Waybill 4 � a <br />