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a? " <br /> ,1 <br /> CHAIN OF CUSTODY RECORD <br /> SAMgMnor � <br /> %�! i � SHIPPING INFCRMATIAN <br /> -'-Phone: G� �. -- KLEINFELDER, INC. <br /> SHIPTOc _- .�� Shipper 1975 F STREET <br /> Address FRESNO, CA 93706 <br /> I �~ 4203 %1r. S'WiF"l ,C.1lV _ Date Shipped 1 -- <br /> «, E!ii , /22 <br /> Shipment Service <br /> Airbill No. <br /> n <br /> ATTENTION: Cooter No. - <br /> Phone No. s a77-5 <br /> h Sign u eceiv d by:(Signa e) t Time <br /> i n she a rat Vi�ven <br /> nor ) D to/Time <br /> t <br /> el n (5tQnaru J atural Data/lime <br /> i <br /> I Rei nclu a e y:{S(Qnature) Receive tot laboratory b %(signauura) Date ime <br /> z <br /> w, <br /> *Analysis laboratory should complete,"sample condition upon receipt",section below,sign and return top copy to <br /> J.M.KLEINFELDER&ASSOCIATES,1975"E"Street,Fresno,California 93706. <br /> Sample Site Fate Analysis Sample Condition <br /> . Number Identification Sampled Requested Upon Receipt <br /> -737,637377 <br /> e <br /> r' <br /> 57, <br /> kr <br /> 373 79 <br /> j 37,3„ dA <br /> 3V - �ik i - <br /> f 3`731';t <br /> f <br /> r$ <br /> { LAS INSTRUCTIONS: Laboratory reports should reference and be billed by site 100 and contain the fallowing: <br /> a <br /> (1) summary of analytical methodology and QA work {blanks, spikes, duplicates) <br /> IM dates for {a) sampling, (b) lab receipt. (c) extraction, (d).injection/analysis <br /> . det tianlimits for all cons is analysed for and repo tin af,all conztituants detracted which jw�are not <br /> s i##call designat f 1 we Nolreso ris4h <br /> "SIS) <br /> - - <br /> White - Sampler' Canary - J. H. Kteinfelder i Associates Pink - Lab Courtesy Copy <br /> JHX&A Form Mho <br /> i - - _ <br />