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4080 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD -� _ 31C <br /> GTELCONCORD,CA 94520 AND ANALYSIS REQUEST(510)685-7852. (800)423-7143 1 , 1 . , �:�rtlr111 IMG 7r <br /> �`. r J r <br /> Company Name Phone# (s10 <br /> nIC FAX# S7( 671' I YO I I t it r , i I I i C <br /> Cornpany Address 3 l 'y Sde Location [) h?o frit J1I1�1 �. d <br /> +b !e <br /> ig <br /> i <br /> 6 i O 41 N V a ' 1 I I 1 <br /> Project Manager Client Project ID (#) �, V <br /> i <br /> I� /� :Lo70SS+G . 8 C 3 wl v d I I m 1 m m r <br /> �,kro Or Sacro m LL a I t <br /> t– D a r r <br /> I attest that the proper held sampling Sampler Name(Punt) d Iln o -J a <br /> procedures were used during the n 4} C 0 � 1 1 � � w I I 11 m <br /> collection of these samples �Z i `r' - <br /> W 9 d G O N R Ot r) 1% 11 f rl <br /> p LL ry [� 1 U 'n o d 1 I 1 1 i n (1 ' <br /> Method - �, m .� m o <br /> Matrix Sampling o �, II o W a Q m „ r <br /> m y 4 i w w lea 2 lu <br /> - w i <br /> Field GTEL Preserved I t a I I 11 I i 1 1 a s u ro m J. <br /> ^' y <br /> Sample Lab# T3A <br /> W W_ `� a � S § . - X 2uJ <br /> ID (Lab Usel W ` W w a Q C a a a aMonly // r7i W o a a a a a a a W R a 0 O_ o i= m Y ( lL w w w w w w w w w <br /> to <br /> F [ 1 1 $ - <br /> $ j 1 N1 I ' <br /> Wwal LS 64-0 rL IS)- <br /> 03 11, 1 _ __ 1639 _ <br /> 3NV <br /> 1 13 st <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS A) �c <br /> prionty{2d hr) GTEL Contact _ ----- .,�+ •Is l - INP wAi KVP C i �- t( �►'h111, f•� 3 L <br /> Erperpted148hr) Quote/Conlracl N�<<r3Q� Fy l eco L~ql i is weal r.0 l' Y3 �cfr�1. I.1 3 hl, 33 <br /> 7 Business Days Confirmation 11 S(a✓ k1"r WM OWN -(�( «t<+hi.. S)+n <br /> Other <br /> Buse�ess Days � P O r _ SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot N Slaragn onnitan <br /> C L(0, 0Z` '7 - Fi ItegY Sox S <br /> QAIQC Levely- Q QO <br /> Blue CLP r other I � - — FAX[] Work Order 4 (�570z C16 ---I7 //ke) <br /> Relinquished by Sampler Patq Time Received by <br /> CUSTODY AN56 sljfh� 1,1536 <br /> RECORD Relinquished by V Dale Time Received by <br /> Relinquished by Dat t Time Received by Laboratory u3q� ` <br /> S/P �`�`? 4L, ijr Wa bili It .�1*-.�'1?l yt' 4^ i` <br />