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�. <br /> = {��_-AA C 1 FGL ENVIRONMENTAL �_�AIN-O&CUSTODY C® +-�s PRaJECT <br /> f cl . <br /> (lice Reverse for Instructions). NO, <br /> PROJECT NAME AIL r rD "y a. -- SAMPLERSSAMPLE CONTAINER SAMPLE DESCRIPTION CODES TAT CODES <br /> rr {PR/typd �� DESCRIPTION CODES w Ground water F.Od <br /> Pl�OJECT NUMBER?�ILhil` '�T A k« -i � ' A 40-rnlN A Vial R Surlaca Wale, G Waste 1.Slandwd r <br /> j _� ISIG I S.Glass Uor E.atass Tube C.Leachate H alanLjSpRe 2 5 Day - <br /> s°,: t <br /> DER— �` -��� C.Plash[500m1 .Other--.__ D-AmSeale t Other _—_ 3 60 Hour E <br /> LLL I <br /> (SIGN) - D.PleShl:Leer ,�_..__.—_ E.SaIVSedi -t _ _ 4 Omer _.._ _.—_ _ .. — x r <br /> AECOR <br /> T NurdueRaP ANALYSIS REQUESTED LABORATORY USE ONLY <br /> CONTAINERS u _ <br /> AND $ r� <br /> - - E E_ . '.fir I . tom .•tt 5 <br /> PRESERVATION <br /> LE <br /> NOTES <br /> SA� <br /> - <br /> N TES ASSIGNECCONDITION <br /> BOTTLE UPON <br /> RECEIPT ID g P <br /> NOTjEf <br /> SDTE TIME. <br /> Sr <br /> , <br /> 7'Y"7kj <br /> tis l✓ � e. ,'`�^ X �, � <br /> Lj <br /> NO ES l MISCELLANEOUS R/ey'��t qw(/y hed by (Signature)A .� R o)ved :(Sika to Time <br /> ce ftes ; D•/31 EH ,ao-y''Y! ? W� �,a,,� ,, i " •... ���� <br /> �j j t ,. <br /> Relinquished By:(Signatu(e): _., r :(Slnr _ - Date Time = <br /> �,/ r Ttma <br /> s� S r e 1 <br /> /lt�• LtrR _ R Lin wished 8 : Si nature Rete' <br /> 1rC Rr H '?Y"s <br /> Method of Shipment Description of Other Chains-Of• ustody Dispatched By:($jgnature) Date Time Received[or tab By:(Signature) Date Time <br /> _,,= <br /> Container I Transported with this Chain(by Serial No.) <br /> LQ:3�9 L G� <br /> Send Lab Results to(Name): (Check Office Below) Verbals Requested:Yes ❑ No ❑ s <br /> s <br /> © SANTA PAULA STOCKTON �. ❑VISALIA <br /> TEL(805)659.0910 �TEL (209�442-9181 .�%�•`1 � TEL(209) 734-9473 a <br /> FAX (805)525-4172 FAX (209)942-(429 1 I / y ) :'i•F f�t /F4X (209)735-4273 <br /> ti FGL ENVIRONMENTAL LABORATORY•2500 STAGECOACH ROAD CA�45215+TEL.(2M)942, Wt•.•FAtVW) t <br /> l IA HITE.Fuld Cry, YU.I.UWr Pru)w Otpy MNK:Lmaau.j C," <br /> at <br /> l <br /> {I i <br />