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2795 2nd Street, Suite 300 <br /> /FF Davis, CA 95616 <br /> Lab: 530.297.4800 <br /> ANALYTICAL ccc fax: 530,297.4606 Lab No. ! - Page-)-- of <br /> Project Contact(Hardcopy or PDF to): EDF Report? ®Yes ❑No ' <br /> R. Smith Chain-of-Custody Record and Analysis Request <br /> Company/Address: Recommended but not mendstM to complete this owtlon_ <br /> HORIZON Sampling Company Log Code: DE10 Analysis Request <br /> Phone No.: FAX No.: Global ID: T0607700492 m x <br /> 939-2170 939-2172 m m <br /> Project Number. P.O. No.: `[ EDF Deliverable to(EmalI Address): 9 m m <br /> 3641 Stockton 3641�� 21 <br /> rsmith@horizonenvironmental.net N w J Y = <br /> Project Name: Beacom Project Address: m : a e O <br /> Stockton P o m to 0 o QQ Q N h Z fn <br /> Sampler signature(below): 00 ~ <br /> ,v. ►- LLLLLLram a�i N <br /> O <br /> Cl) <br /> tNQ U- <br /> >> cccz= m <br /> w WE O Z <br /> IL <br /> $ m le Designation Date Time vLu <br /> _ _ 3 N F F 0 0 o m W } m <br /> vw - -3-og X2.313 <br /> Relinquished by: Date Time Received by: Remarks: <br /> Relinqui Date Time Received by: <br /> Relinquished by: Date Time -Received bv Laboratory: <br /> :\\/d\q%A Bill to: <br /> OistrMution: White-Lab, Pink-Originator <br /> Fortnslcoc 121001.M <br />