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0 <br /> 720 Olive Drive,Suite D <br /> Davis,CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICAL LLC Fax 530 297 4803 Lab No C-7-3 Page of <br /> Protect Manager Prone No <br /> �.. Chain-of-Custody Record and Analysis Request <br /> o c t7(`{ g3� -� 32 Y Y � q <br /> Company/Address FAX No <br /> I—" I— For Lab <br /> 3 1 4- S,�- 0 i Z Analysis Request use Only <br /> Protect Number PO No Protect Name , o o I _�' WET (X) <br /> 'Noel5 1 6-k Ck i Lk co Oo S Y <br /> Project Location Smiler$jgi to o 0 TOTAL(X) <br /> � 3 <br /> W CD <br /> Container MOhod o 2 " B o o N <br /> Sampling (Type/Amount) Preserved Matrix - <br /> OD x x <br /> 0 — p a- 4 � v W N z t <br /> J C7 •• rn c00 <br /> Q O - o A al V <br /> Sample ' E o Z W x 10 CD 0 <br /> W M 04 <br /> a Co <br /> Designation o -J � z w o Q a. a o0 a ro t <br /> g Qate Time a � ,,, = x v z 3 0a m r- i- ti tow w v N <br /> u9, Z, 2 z Q a ick X Inl <br /> M W - 3 X _02 <br /> L'it►Z y -0 3 <br /> �, w xI y -04 <br /> W lj x W X 10 <br /> Relin shed Date Time Recei <br /> iL y Remarks <br /> P. <br /> eli Xd by Datt,eeTime eceived by Email address <br /> ❑ doc ❑ xls ❑ txt ❑other <br /> e inquished b Date Tlme Re ived by Laboratory Bill to <br /> 2/2 oc� IS'35 &W49 <br /> Distribution White-Lab, Yellow-File Pink-Originator / <br /> COC fhti(9198) <br />