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IFF 2795 2nd Street Suite 300 <br /> Davis,CA 95816 �� h <br /> Lab 530 297 4800 Lab IVa V Page of <br /> ANALYT/CAL ccc Fax 530 297 4808 -- — <br /> F <br /> oject Contact(Hardcopy or PDF To). Califomia EDF'Report? R]Yes ❑No Chain-of-Custody Record and Analysis Request <br /> w Van Allen <br /> mpany 1 Address .commended but fiat mandatory to complete this section Analysis Request Q <br /> x Envirotech,lnQ Sampling Company Log Code <br /> 11244 Pyntes Wy Gold River,CA 95870 APEF _ <br /> Phone No Fax No Global ID °0 12hr <br /> 916-851-0174 916-851-0177 70601193593 <br /> Project Number PO No EDF Deliverable To(Email Address) m o 3 24hr <br /> COH01 001 cmarttn a exenvirotech com m o w ° p <br /> Project Name Sampler �, m v m ni CO -J m <br /> Cohn Property Signature $ @ ed w 48hr <br /> Project Address Sampling Container Preservative Matrix m W @ z x _ O r <br /> M — n 0_ N N O _ �y <br /> 3755 Munford Ave,Stockton Q a o m m m m = m o 1 Wk LL <br /> Sample ° W Of D a o H C C C r o N <br /> XLU co <br /> x x X m Q R <br /> 274 Be <br /> Designation Date Time v i a ¢ s i v z m o 0 0 o in r- J W m O <br /> U F,DW 3602 1130 X X X X X X 1 wk `q <br /> DW 3604 Iwo X X X X X X 1 Wk -aZ <br /> DW 3606 115,0 X X X X X X 1 wk r0 <br /> 3 . <br /> Relrn ulshed by Date Time Received by Remarks <br /> 3",(1;, <br /> Temp°C Therm.lDZ- l <br /> e quished by e Receive <br /> Date Timd by nitiail <br /> Data–=t Trina l <br /> Coolant proaant• <br /> Relinquished by Date Time Recef by Laboratory Bill to <br /> �4qI <br />