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2796 2nd Street, Suite wo <br /> .� Davis.CA 95616 <br /> ANALYTICAL LLC Lab: 530.297.480o <br /> Project ContactDF to): Fax: 530297.4808 --- Lab No. Page or <br /> R.Smith EDF Report? [Eyes EJ No <br /> Company/Ad 0_ Chain-of-Custody Record and Analysis Request <br /> ecUon: <br /> HORIZON Inpido this a O� <br /> Sampling Company Log Code: <br /> Phone No.: '!. fD fEI 0 Analysis Request <br /> 939-2170 FAX No.: Global,D: T0607700492 <br /> 939-2172 <br /> Project Number: P. <br /> EDF Deliverable t Q Uj <br /> N CM <br /> 3641 Stockton <br /> 3641-106 rsrnith@horlzonenvironmental.not <br /> Project Name: R 'l <br /> -P;7qec-'1'Address: <br /> 0 <br /> Stockton <br /> Sampler Signature(below): LU ia Lo W <br /> 4a <br /> Sam <br /> M 20 g C, <br /> ng a CL I <br /> Itallner 1111ve 0 1z t: (I B <br /> 8 <br /> ; a QU. M Go <br /> z o <br /> > -2 0 <br /> LL <br /> LU <br /> mole Desi natio8 <br /> 0 <br /> Date FTma 0 <br /> Lf) h J IL <br /> A4 LL-' 7-0PIC <br /> /VJ <br /> '61 02 <br /> 0'3 <br /> Relinquished by; <br /> Date Time Received <br /> Remarks: <br /> Relinquished by: <br /> -Date � Time Received by-- <br /> Relinquished by: = Dale Time Received by Laboratory: Bill to:��4 1 t 7 1 AJ AYVA-W <br /> Dist6buWn: white-Lab, Yellow F99.Pink-Originator <br /> Tyr )Z 013 <br /> Formrdooc 121001.1h9 <br />