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ANALYTICAL 720 Olive Drive,Suite 1) lab:916.297.4800 <br /> LLC Davis,CA 9.5616 Fax:916.297.4808 <br /> Project Manager: Phone No.: <br /> 916 .9x3_ Chain-of-Custody Record and Analysis Request <br /> Company/Address: FAX No.: For Lab <br /> !�Sl1 - .,3 f�/C��>a 0 Ca�P�Q• �6c� JAG vS� —92 9�" Analysis Request Use Only <br /> Project Number: P.O. No.: Project Name: WE.T.(x) <br /> �s. ?rON Sl.+-ho.J �2" � �+ <br /> 07y0C)/e TOTAL(X) <br /> Samp�Signatr/X Project Location: � 3 <br /> _ <br /> W co N <br /> Container Method m 0 I <br /> Sampling (Type/Amount) Preserved Matrix o N m z t <br /> 0 tj o n a N N v <br /> to N o = o Lu 00 C14 04 04 <br /> _o m m v� v a Z v <br /> Sample Q W ; o z W x Q Q Q Q Q M <br /> o U z w 0 a a a a a a a a a o cv <br /> Designation ^ Date Time W Ln _ = U z m m f- h- w w w w w U U <br /> fi-�Fe 13:o0 - ----- - -- - ---- - ---- — <br /> Relin ed b Date Time Received by: Remarks: <br /> 11-60-16, 4:0� <br /> Relinquished by: Date Time Received by: Email address: <br /> ❑.doc ❑.xis ❑.txt ❑other <br /> Relinquished by: 1( ate Time Re eived by boratory: Bill to: <br /> Distribution: White-Lab, Yellow-File.Pink-Originator MGM <br />