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2795 2nd Street, Suite 300 <br /> .�� Davis,CA 95616 <br /> Lab: 530.297.4800j <br /> ANALYTICAL LLc Fax: 53D297.4W8 Lab No. 2-19 mage f °r <br /> Projegon (Hardeq y or FDF To): California EDF Report? Yes n No Chain-of-Custody Record and Analysis Request <br /> Company/AddressH� . <br /> i b e'I"'�I°" <br /> r � Sampling Company Lop Code:�. • i -� Analysis Request <br /> x <br /> Phone No.: FAX No.: Global ID: m m o <br /> Ld <br /> o- -O . � �~().d -Z mLd <br /> m <br /> N <br /> Project Nu ber. P.O.No: EDF liverable To(Email Address): m m o X <br /> 1 8 t O <br /> P Name. �j Sampler Signature: w n W in � .� o N <br /> a- a- N m g � iv .moo <br /> Project Address: _ <br /> Sampling Container Preservative Matrix m +3 m a m o a - ` Co 75 `o <br /> Q N L O m m m m > m 4 "` L LL <br /> co <br /> w w J x m m c i w M C <br /> 2 r ?� x 9 x m r <br /> iJ z w O 4 0 r = a. (a 0 O O <br /> Sample Desi nation Date Time v m x x �? z m m m r r tn r- tn r- <br /> -344 <br /> - <br /> w <br /> 3 , <br /> Wq <br /> 31316if 690 31 1 <br /> �.qd <br /> i <br /> ;s V� <br /> (:Do 1 . _ o <br /> t� I I T I Ili L I 1 . 1 L <br /> 5 ';SS b <br /> Relinquished by: D Time Received by: Remarks: <br /> Relinquished by: Date Time Received by: <br /> Relinquished by: Date Time Received by Laboratory: Bill lo: <br /> t2LVIti N' " t Cl y' <br /> -pistribution: White-Lab,Yelbw-Fiie.Pink-Originator slcoc 121001.1h9 <br />