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CHAIN-OF-CUSTODY RECORD CUSTODY RECORD <br /> 4080'Pike Lane AND ANALYSIS REQUEST 72- `-/0 J.9 <br /> Concord,CA 94520 1. 800.544.3422(!n CAI <br /> r111Y1 R O 11 M E 11 I A L 415.685.7852 .`I aoo-423.7143(OL:ISidu CA) ANALYSIS REQUEST <br /> ® LA90RArDRIri IIIC <br /> Phone n' n.q' <br /> Protect Manager. a w j <br /> Y'.. FAXar: , (aT1 J�3C �+ 010 D' mI - <br /> n Cn m <br /> U -_-_—___- S_il..c.-lo.-cation..: <br /> Address: .. —"c 1 �lsN+nI <br /> I'J gy <br /> 21 <br /> UJ, Vai= <br /> T! �! � m 2IUOi l+ . S <br /> I <br /> yIl <br /> r <br /> 171LL h+. N r/ <br /> Project Number Project Name: i m in:p' E j I o I L1!^ 6 <br /> f r`1 115e P�nlY�7 $ O Q ,aI IZ zinluli Nim ~ , 11 <br /> O (J c'/ .... L11 [l l n u !7 ❑i `' <br /> attest that theLproper field sarnpling Sampler Na ( "' 2,' I i i, ❑ w m n l v 1 <br /> procedures were used during the collection o m n m r°v n Ll I❑', p ❑ L n o <br /> of these samples. �7�U /r� o o' n4 r o ololo'ol,olrl -Il� q1 r <br /> fi flG��1 r21a,� [] 1 I' ? I�!LL I \ <br /> Field Sourre GTI=` m O' N °° uI M1' o` ❑ y <br /> Matrix Method Sampling m T v 1 o i o o n n°n j a E v l I❑ 1 5` J <br /> W in <br /> Preserved I - [] U I I I m m¢= i .a 'a 9� <br /> Sample r;f Lab# z_ - 111 c� c� p � ❑ '�;❑ ❑�❑ ❑ �- INj�I�IC; <br /> ID S3m le Lab use a Lu aI CLr f� o lin m Icl•co10 v n . I ? a n) of a <br /> P ( r- Lu W n vl0 ai�!Ur n�� m p a alnl z2' > > > . <br /> only) Z w o w O O z Z rw- w x x f i m m m <br /> to w w wlx:o m'bl¢jS,a�s�¢I¢Ir-1J ¢.a I c Chi <br /> � a¢ ? r U z V O>- ¢ / ai o'0 41a,0.,a,a a alc� a .jjalo e i <br /> u rnarn0 = Z T _ Z • Q r m'm r i;l r, u,w'wlwlw,w:w r LII=U,U1 ¢ Z ¢ I <br /> l t <br /> E ! E E <br /> f <br /> �I t :. <br /> �: 1`1:'/-13 Tarr•%Y _�..._ S �!'� 9.'jp <br /> ID �t <br /> BIW-/o bn,lev S .. . �fj� s _ I — I — i�•� +aI��I� i8 <br /> I <br /> - lt� 'tea•rGV- ._._�. - -� _. - � � � __ I 1 k i I I I i � l � � 1 I l ' - <br /> SPECIAL HANDLING SPECIAL DETECTION LIMITS(Specily) REMARKS: n�i ;Y <br /> 24 HOURS M <br /> EXPEDITED 48 Hours ❑ <br /> sr n <br /> SEVEN DAY 0 <br /> OTHER-(#) BUSINESS DAYS ,�2 Z, <br /> ON•C]C CLP Level C1 Blue Level El SPECIAL REPORTING NEOUIRGMENTS Lab Use Only Storage Location 'v Q Q <br /> FAX,/ k` I (Specily) Lot u: Work Order 1t: (D m a <br /> ac <br />