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2795 Second Street, Suite 300 Calscience ���®�®0014 <br /> Davis, CA 95618 7440 Lincoln Way <br /> 11 z%,if F F Lab: 530.297.4800 Garden Grove. CA 92841-1427 <br /> Analytical LLcO Fax: 530.297.4808 714-895-5494 COC No. 85552 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 Due Date <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 /> 0 M <br /> 211602385.600.0800 85552 inbox(d_)kiffanalytical.com � o 0 <br /> N <br /> Project Name: Container/Preservative Matrix w <br /> Co tL N <br /> Parcel 2A vM o j <br /> Project Address: o o oN <br /> Sampling o N Z 2 i- (0 � L <br /> Z = T m o a <br /> U. <br /> 0W-0 M O W N W Q <br /> Sample a � (b U) .0 <br /> Q - <br /> Desi nation 7 � � L <br /> g Date Time .- N = — � <br /> GW-EFF 07/30/13 09:45 2 2 1 X I XXX X <br /> Relinquished by: Date Time Received by: Remarks: Please provide EQuIS. <br /> m <br /> elinquished by: Date Time Received by: <br /> rn <br /> 0 <br /> Relinquished by: DateTime Received by Laboratory: Bill to: <br /> Accounts Payable 00 <br /> Retu.,,..,...,,...,,., 1� <br />