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e' <br /> 11-08-0877 <br /> 2795 Second Street, Suite 300 Calscience <br /> KIFF Davis, CA 95618 7440 Lincoln Way <br /> Lab: 530.297.4800 Garden Grove, CA 92841-1427 <br /> Analytical LLC Fax: 530.297.4808 714-895-5494 COC No. 78419 Page 1 of 1 <br /> Project Contact(Hardcopy or PDF to): EDF Report? YES Chain-of-Custody Record and Analysis Request <br /> Jennifer Worsley <br /> Company/Address: Recommended but not mandatory to complete this section: <br /> Kiff Analytical Sampling Company Log Code: SIRC Analysis Request TAT <br /> Phone No.: FAX No.: Global ID: SL0002050099 <br /> 530-297-4800 530-297-4808 <br /> Project Number: P.O. No.: Deliverables to(Email Address): <br /> 211402841.300.400 78419 inbox kiffanal tical.com ;n o <br /> Project Name: Container/Preservative Matrix C 0 N <br /> Parcel 2A = Q <br /> Project Address: Sampling NN L <br /> o <br /> U. <br /> (DC <br /> Sample E o <br /> Designation � <br /> g Date Time - i <br /> GW-EFF 08/11/11 12:00 2 X X X <br /> Ref quis a y: ®Date Time Received by: Remarks: <br /> k-fich�)Ri CLQ ®� I &04 T) <br /> elinquished by: Date Time Received by: <br /> Relinquished by: Date Time Received by Laboratory: Bill to: <br /> ©Nf/�rC- �� .l, /V-001 Accounts Payable <br /> .................iients F <br />