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r' <br /> �JVACL <br /> � 2795 2nd Street Suite 300 <br /> Davis, CA 95$1S �r )Lab: 530.297.4800 Lab No, t�� Page 1 of 1 <br /> AYT/CAL ctc Fax: 530.297.4808 — — <br /> Project Contact(Hardcopy or PDF To). California EDF Report? ❑yes No Chain-of-Custody Record and Analysis Request <br /> Kasey Jones <br /> Company 1 Address: k0commended but not mandatory to complete this section: Analysts Request Q <br /> Apex Envirotech,Inc. Sampling Company Log Code: F <br /> 11244 Pyrites Wy.,Gold River,CA 95670 <br /> Phone No.: Fax No.: Global ID: ❑ O r <br /> 916-851-0174 916-851-0177 0 ui <br /> Project Number: P.O.No.: EDF Deliverable To(Email Address): <br /> ERV01.001 m m o 24hr a' <br /> UJ � ❑ 0 0 <br /> Project Name: Sampler � �;, ED ° W N a -J 48hr <br /> E.R.Vines Signature: w 0 c w m m ca t' <br /> m m O A <br /> Project Address: Sampling Container Preservative Matrix _ m r (O m u -" _ ~ r <br /> O ?Z JZ °N.° 91 � -e ci 0 6 <br /> 4733 Hwy 99 Frontage,Stockton 0 o z 2 o CO1 m � ro � m � ry 1 wk LL <br /> n <br /> Sample ° , rr o v m .� N <br /> E w m 0 z ham- J x to j <br /> X x x x Q m <br /> Desi nation Date Time a (L ¢ z = z 3 m a o o J W > J 20 <br /> 5S11 aj 1:35 X X X X X 1 wk <br /> 6S 1:45 X X X X X 1-wk 02- <br /> 7S <br /> Z7S 2:00 X X X X X 1 wk <br /> .j <br /> Reli wished by Date Time Received by: Remarks: <br /> �,(� ('1*a3 400 <br /> linquished by: Date Time Received by: <br /> Relinquished by: Date Time ceived by Laboratory. Bill to: <br />