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2795 2nd Street, Suite 300 <br /> Davis,CA 95616 <br /> A Lab: 530.297.4800 <br /> Project Contact(Hardcopy or PDF to): Far RM 9p7 dRl}t{ _ _ Lab No.. Page of <br /> R. Smith EDF Report? ®Yes ❑No <br /> Company/Address: Recommended but not mandatory to complete this section, Chain-of-Custody Record and Analysis Request <br /> HORIZON Sampling Company Log Code: DEIO <br /> Analysis Request <br /> Phone No.: FAX No.: Global ID: <br /> 939-2170 939-2172 T0607700492 in90 M <br /> x <br /> c <br /> Project Number: P.O. No.: <br /> EDF Deliverable to(Email Address): <br /> $MmlthQhorizonenvironmental.netStockton 3641-3641 n <br /> Ui <br /> mco <br /> Project Name: Beacon o W W N M Project Address: C <br /> p <br /> N ID F F m <br /> Stockton <br /> LU o0o Z; 2C7 c9 m w H <br /> Sampler Signature(below): m <br /> W ¢ N h N <br /> 5amptingContainer Preservative Matrix _ o a m N L <br /> \ o m m o m m m L m o ff o <br /> w N x <br /> '_J m (] '2 w C d O W N t ti <br /> E uwi <br /> TZAR z H _t X w W 0 c+ v+ �' m o C Nm le Desi nation Date Time v cwi z tw- a. E a 0 0 0 o m a o io r <br /> m Ln w N <br /> M t.A- - la: fa <br /> 17 <br /> NIw — 5 a1-55 a �' <br /> AA <br /> W — 6 Jo:o <br /> VW— <br /> Relinquished by: hate Time Received b 1 <br /> y Remarks: <br /> ReiingUis Date Time Received by: <br /> Relinquished by: Date Time Recelveg by Laboratgry; Bill to: <br /> pshfburiort:' '.9-Lob, Pink-originator <br /> Ooc 121 ot)1 lh9 <br />