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t»»»»� �ttitiiiiiil>i � t� � � � � i• � � � � 1• �.� � <br /> TestAmerica Nashville Division Phone 615-726-0177 <br /> 2960 Foster Creighton Toll Free 800.765-0980 E3f(pnMobll <br /> .C°•1.A.I 10 Nashville,TN 3T204 Fax 615-726-3404 <br /> Consultant Name ETIC EIINGINEERING Report To Doug Fitzgerald <br /> Address 2285 MORELLO AVENUE Invoice To Jennifer Sediachek(XOM PM <br /> 398936 City/State/Zip PLEASANT HILL,CA 94523 Account# 10236 <br /> ETIC Project Mgr TED MOISE Po it 4504349422 <br /> Telephone Number (9;N5)_602-4710 EXT 23 Fax No (925)602-4720 Facility ID#7-3942 <br /> Sampler Name (Print) t` -po-eilt,a,-Or- Site Address 4444 N PERSHING AVENUE <br /> Sampler Signature City,state Zip STOCKTON, CA <br /> Preservative Matrix Analyze For <br /> ^y N <br /> 0 ¢ m S b <br /> dt <br /> C to <br /> CL a <br /> N W U m V_ 9 1 'A I S 1tl OD a F �Fp c n f Cr Q Vl <br /> W O a '� E T V Z= i E ; ��7o Y m cr ru a R `" r 2 <br /> O H Z (7 0 w x x x x x x i U'� S O rq cnn q 0 '� a 7 o Q H <br /> Sample ID l Description a uy u- <br /> MW-13 W901 1� 13'30 to X X X X X X <br /> SRW-I 0; t 13s X X X X X X X <br /> RW-2 V'� t 12r� U X X X X X X X <br /> RW4 p 12/1 1-vor to X X X X X X X <br /> V-1 s 'Z& I oy (F X X X X X X <br /> .. V-2 Q 'ZfZ to,y G X XIx <br /> X X X X <br /> V-3 07 ZYI 1 Z'it (i X X X X X <br /> V-4 ry tZ j t•y,y "� X X X XIX X X X <br /> ,. Sw1 o to I y,, X X X x x <br /> SW2 )p `I toT 1P X X X X X <br /> —' UVB-MW 1 )/ (& X X X X X X <br /> UVB-Mw2 991 >3 S x x x x x x <br /> GLOBAL ID#T0607700019,EDF FILE REQUIRED Laboratory Comments <br /> Temperature Upon Receipt <br /> Sample Containers intact? Y <br /> Samples to be tested for Manganese are unflitered,lab to Filter prior to testing VOCs Free of Headspace? (2) N <br /> Relinquished by v 4 p t�a x� Date% pTime Received by- Date Time <br /> Rehnquis by "ww r1weAA,iy t Date Time Received by TestAmenca Dale Time <br />