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I Y-0 600��5 <br /> OG McGampbell Analytical, Inc.. <br /> CHAIN OF CUSTODY RECORD <br /> W� 1534 Willow Pass Rd./ Pittsburg,Ca.94565-1 JOl TURN AROUND TIME:RUSH[a 24 HR(a 48 HR Q 72 HR O'5 DAY 10 DAY C <br /> www.mccompbell.com/ main@mccampbell.com tieoTracker EDFQ PDFQ EDDQ Write On(DW)Q EQUISQ <br /> Telephone: (877) 252-9262/Fax (925) 252-9269 <br /> Effluent Sample Requiring"J"flag UST Clean Up Fund Project;Claim# <br /> i <br /> Re ort To• i2 53er Bi11T . e. ^^ R s ci ?.nal is Request <br /> company: � i iw%eu view if-6 befoirf-r""I <br /> 1 b C czx OY\ e 9 ; <br /> iq F 9 <br /> r y Y E-Mail Ps`5"r S' e d.ccn r = f. r <br /> ,� r e 9 <br /> Tele: 2,a°l -o3'13 Fax: of - � � a <br /> Project#: ixqlqi2WC Pro•ectName: Wofir W?Wtil— q a U z a s e r'^ W <br /> Purchase Order# "- r " e 4 `� e <br /> Pro•ectLocation: J ( oo "g 3 e l� <br /> Sampler Signature: ''� e i ` U C > i ; <br /> MATRIXMETHOD m, O e i S2 v <br /> SAMPLING PRESERVED « n oo <br /> 8 c : z - `a' k i °' A S- e to z; <br /> L .w. y v •v y K ry .Qi ti V b w e; u 4' 0,Locatiod v .. „SAMPLE ID ield Poiu 3 aName DateTime U '�u v 3 a0 x � o <br /> P� IrT"f <br /> Z=5�5 XFT <br /> CID xL e _ _-r x <br /> x <br /> .6 e o" 3: <br /> B e -Z 7 <br /> - S <br /> ••MAI clients MUST disclose any dangerous chemicals known to be prrsent in their submitted samples in concentrations that may cause immediate harm or serious future health endangerment as a result of brief, <br /> gloved,open air,sample handling by MAI staff.Nondisclosure incurs an immediate$250 surcharge and the client is subjecfull legal liability for harm suffered. Thank you for your understanding and for allowing <br /> ustoworksafel . COMMENTS: <br /> Relinquished By: Date: Time: Rec ' d ICE/t, <br /> 'S(4 K/ HEAD SPACE <br /> ,Send SJ Eli <br /> HEAD SPACE ABSENT_ !a, <br /> Relinquish¢ y:n te: rimes: e' By: / DECHLORINATED IN LAB_ - �� 1( '�0 �11QiI a• Andl r5c') <br /> /hJ ✓ /N APPROPRIATE CONTAINERS_ �. <br /> / ( PRESERVED IN LAB_ <br /> Relinquis"lly: Date: Tim . eived By: VOAS O&G METALS OTHER HAZARDOUS: <br /> PRESERVATION UHa <br />