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2795 Second Street, Suite 300 Calscience <br /> KIFF Davis, CA 95618 7440 Lincoln Way 2� <br /> Lab: 530.297.4800 Garden Grove, CA 92841-1427 C, <br /> Analytical LLC Fax: 530.297.4808 714-895-5494 COC No. 78182 Page 1 of 2 <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: SL0O02050099 <br /> 530-297-4800 530-297-4808 <br /> Project Number: P.O. No.: Deliverables to(Email Address): o <br /> 211602258.400.401 78182 inbox kiffanal tical.com N 0 <br /> Project Name: Container/Preservative Matrix W O <br /> cc <br /> Parcel#2A-3Q11 Monitoring and Sampling <br /> Project Address: Sampling o J <br /> Z ° o <br /> N U. <br /> a _ <br /> Sample E <br /> >r <br /> Desi nation `° 4) <br /> g Date Time n <br /> MW-33 07/19/11 11:10 2 X X X <br /> MW-32 07/19/11 11:20 2 X X X 2- <br /> MW-25 <br /> MW-25 07/19/11 11:35 2 X X X <br /> MW-26 07/19/11 11:45 2 XI I X X <br /> MW-44 07/19/11 12:05 2 X X X <br /> MW-45 07/19/11 12:25 2 X X X G <br /> MW-28 07/19/11 12:45 2 X X X <br /> MW-27 07/19/11 13:05 2 X X X <br /> MW-31 07/19/11 13:25 2 X X X <br /> MW-34 07/19/11 07:24 2 X X X i d <br /> R ' ui he y: Date Time Received by: Remarks: Special pricing of$185/sample. <br /> WrA/t Ca t7 72011 po <br /> elinquis ed by: Date Time Received by: <br /> Relinquished by: Dae Time Received by Labor t Bill to: <br /> 1�1�� t ® Accounts Payable <br /> Ret-.-n to Confer, <br />