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4080 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD 36362 <br /> GTEL CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> e (510)685-7852 yyi <br /> lwri.ow of hlrl Sws I� i�'p? 1 7 <br /> f .0 (800)423-7143 <br /> Company Name Phone# b� 3 Z S t F I <br /> PWAilge irah tti1 q� FAX# 91b) 3S`1- 31� <br /> ❑ v < <br /> Company Address Site Location m = a F I <br /> I`lb � C xtav WA But f 200 r1 ❑ c <br /> c ur 9S SJ �1tWilt, L14ftery r N d ii n a u l_I <br /> U ❑ <br /> ro)ect Manager Client Protect ID (#) + ± e p < a <br /> T f} $ TCG ❑ ° `� m m o ❑ <br /> JIQS� � 1\Q��4 �J NAME m 1� o ❑_ N f7 y1 z z i1 c C] tI ¢ <br /> I attest that the proper it Id sampling Sampler Name(Punt) ❑ `� v 0 ❑ ❑ a E 0 <br /> procedures were used during the J� L a a T ❑ ❑ m a a `-' Zi n <br /> collecUen of these sam les v a S �' a u o N ❑ fLn � `„ o o a Q o v ❑ a �' ❑ a <br /> 0. N v n a ❑ ,. <br /> Method O V o v W a as a�a ago © co m ❑ ❑ >j `o o ro <br /> Matrix Sampling a s d ❑ w CL a o ❑ ❑ F, ❑ a N ❑ <br /> Field GTEL W Preserved © _ q C 0 ❑ ❑ w w m a a m N ❑ <br /> z a �° m `A g 0 ❑ a a ❑ g �° m N <br /> Sample Lab# ¢ w ¢ ¢ c7 �" o 0 0 o N N X N <br /> �� Lab U52 z w p o w n w°w wr w w X ? c n m m co co co m O a 4 o <br /> if J O x o fcn x H w w v a = m a a a a a a a a <br /> ` only U 4 p ¢ J ¢ h U Z a U zw FN a - t- a a, — a O d a a a a a a 0. U a y rn o <br /> a m ¢ rn a o x x M. SW Q_ o m m = = O F- w w w w w w w w w F w v O v <br /> VW 3 X I <br /> VW <br /> P+X <br /> X x 8 3 I So <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> Priority(24 hr) n <br /> GTEL Contact — ��� t L LF y " L <br /> Expedited(48 hr) I I Quote/Contract# <br /> 7 Business Days X Confirmation# <br /> Other SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> Business Days ❑ PO # <br /> OA/OC Leel <br /> Blue 77 CLP E7 Other❑ FAX g` 3 Work Order# <br /> Relinquis d by Sample rate l� } t Time Received by <br /> CUSTODY `" "` �v�� !�� <br /> Relinqui a by Date Time Received by <br /> RECORD 14 lei 71 'c7c� <br /> Relinquished by ate Time Received by)4aboiatory <br /> Wa bill4 <br /> f <br />