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2795 2nd Street, Suite 300 <br /> .�� Davis,CA 95616 <br /> Lab: 530.297.4600 <br /> ANALYTICAL z_Lc Fax: 530.297.4808 Lab No. Page of/ <br /> P roj Contact rdcopy3rFDF To): California EDF Report? VRYes E:INO <br /> X,X lq= I/f\ 11— Chain-of-Custody Record and Analysis Request <br /> Company/Address: ReowrtrwKWbutnotffwxbftvBoca rykat&socsm <br /> Sampling Company Log Code: Analysis Request <br /> 44N-1-)0-Y) ;\V I I Q I •Q <br /> Phone No.: FAX No.: Global ID: <br /> C2 <br /> f.0 -0 +7 C3 C5.7 co F; <br /> (0 4D CD LL! <br /> 04 C-4 a 3: <br /> Pro'ect Number F5.0. No- e To(Email Address): ez_ <br /> EQF Deliverable 5z <br /> N <br /> 6y%"efA."', C> LU go <br /> Project Name: Sampler Signa re: 2 <br /> (L 0 <br /> 0 4. i;� 0 P <br /> en <br /> cc <br /> a 3 S 04 <br /> N Q r ti <br /> Project Address: a- o- 12 <br /> Sampling Cont or' Preservative Matrix 0 t tz a 0 C4 _J <br /> 'a 0 40 <br /> 0 <br /> LL <br /> W <br /> 73�bc > <br /> LU LU <br /> W .0 <br /> w 0 z t- x <br /> z w 0 0 <br /> (L 0 0 <br /> z F- F- M N. w rl. <br /> Sample Designation Date Time 0 <br /> �YD <br /> TI I <br /> Ti I I L I I I <br /> Relinquished by: Dile Time Received by: Remarks: <br /> MIN. XCO T-A-7— <br /> Relinquish <br /> by: Date Time Received by: <br /> Relinquished by: Date Time Received by Laboratory: Bill to: <br /> Distribution: White-Lab, Pink-Originator Formedwe 121001-M <br />