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2795 2nd Street, Suite 300 <br /> ICiJV2 <br /> Davis,CA 95616 <br /> Lab: 530.297.48{)0rYTICAL uc Fax: 530.297.4808 Lab No. 3$ .5 Page of I <br /> Pro Cor�j�ct(Hai Por PDF 70): California EDF Report? Yes El No <br /> L./• Chain-of-Custody Record and Analysis Request <br /> Com y/Add ss: p � <br /> Sampling Company Log Code:�.�, Analysis Request <br /> �honne No.: AX No.:�/ y / bat ID: m <br /> � T1 �Z. •d CoO <br /> Pro,jrect Numbec P.O. No: EDF ; le ToAniall Adc ss): x <br /> Project Name Sampler Signature: w w o .n w o N <br /> N a� C J2 <br /> m <br /> Project Address: Sampling Container Preservative Matrix a b m m v V O <br /> 0 <br /> 4 <br /> a s !s ffi so <br /> r 2 00 ,Cp cm ro > o m N r U* <br /> O M w W ID <br /> E <br /> LU - U z w p Q p w x x ]: <br /> Sample Designation Date Time <br /> v x x U z 3 m w W) O LU <br /> X x <br /> w N k k X X <br /> X xk <br /> x x n x <br /> Relinquished by: Da4 Time Received by: Rema <br /> 4101(1K 71T <br /> quishhed by: lata rune R Tor M�t3: ki k- *' <br /> BT µ Pb Scud a#` .d b k. <br /> Reilrrquished by: Date Time Received by laboratory: rl Brit to: <br /> r <br /> Distribution: MRS-lab, Pink-onginator Fa msl=12100 A9 <br /> � j <br />