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2795 2nd Street, Suite 304 <br /> Davis,CA 95616 <br /> ANALYT/CAL ccC Lab: 530.297.48M <br /> Fax: 530.297.4808 -Y zzQQ <br /> Project Contact(Hardcopy or PDF Ta): Lab N ']q�J r ease� 2 <br /> California EDF Report? (?Q Yes pt <br /> No <br /> companyfAddi•ess. Chain-of-Custody Record and Analysis Request <br /> H <br /> 5am �p 9 Company Log Code: _ F �. <br /> Phone No.: FAX No: <br /> Global ID: <br /> Analysis Request a <br /> Ff- <br /> at47 151-7-1-7a (0110.73`t <br /> Q x <br /> Td 6 ) I � pQ .ti . g .� �; m <br /> Project Number; P.O. No: t_DF m <br /> Deliverable To(El A <br /> maiddress); g Y 4j I IF C 4D <br /> m x <br /> Project Name; Sal <br /> nature: c m 6 w N 0 <br /> O <br /> w w o w n m ,� W p <br /> Prajeci Address: m c`� c� o ¢ v w <br /> Sampling Container Preservative _ E o F w m v <br /> Matrix _ N <br /> L Q 117 m y N j t m <br /> 5-t>a.C�C� O m L7 n o w N m y J <br /> m o m {� v <br /> > , � m � � .� tmq C c C C �Yp O � <br /> E W w i6 W U a m CI 8 10 z N L �L <br /> ample Designation o _ ° w 0 '- x � � N <br /> Date Time v N c3 z ¢ Q i Q = o o m a jm <br /> ti L)I — m m m M in ^ O � � w � a N <br /> b-3-o3 <br /> Lei <br /> M(IlIz r6- � x X X - � x 1 <br /> MU-5 l;A-03 13:z K '� 02. <br /> M Wy G-3-03 h la K X x x x X <br /> M j.1 S <br /> 6-3-0-5 16,5 x " x xOLV <br /> x <br /> ►`1 u 6-3`a� n:s 5- — - x — ._ — x tt x x ~Sa <br /> x x <br /> Relinquished by: Time x DK r <br /> a k <br /> 6 fJr 3 f f C o Received by: Remarks: <br /> Relinquished by: Date Time Received by: <br /> Relinquished by: " Dale -rime — - — rd 1-AT <br /> Received by laboratory: <br /> M fII J)�] II Bill to: --�- <br /> C <br /> Uisbibufinn: Wleife-Lab, Yvlduw-Frlu,ihnk <br /> /'Vr <br /> Fgrms/coc I2}p01.lT�9 <br />