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M <br /> n�lronmental 3083Goldl.anarDrlve 7 7V-7` -4 0rESID <br /> Labo atones Rancho Cordova 2 TOR <br /> Ph rte 91 5 - CHAIN OF CUSTODY RECORD 03213 INSTRUCTION" <br /> Phone 9161852 6600 <br /> "". Fax 9161852-7292 <br /> Ship To: _ Project Name: / " Gni i�S►T /�7.1 FOR LABORATORY USE ONLY Analytical Methods <br /> 4131 <br /> Laboratory Project#Address: Project Number- � 4132 Long Method <br /> 413 2 Short Method <br /> Storage Refrigerator ID �x. T 4181 Long Method <br /> Project Location: (State) Storage Freezer ID 4 81 Short Meth <br /> 71i Name tpnaturel PPL Worn m F1 d 5 3E <br /> 524 <br /> f{Grp �6 moi/ 'ter - i_ ten/1465531 r <br /> ReL d B5Laee/6-' R tvedMethod o htpinfxtl/Shlpment ID� ^u / Date(C 6012 1 <br /> .; � / r' 7 ,��•'� 602 <br /> Relinquished By DaterFune Received By or M thod of SX <br /> ent/Shlpment I D Date/Tune 604 <br /> f <br /> 610 <br /> Relinquished By Datefrime e d By or Method of Ship m Sh}P'�e jI p Datefrune 625 <br /> -� C53 �-� s ] / .7 00 R p—I 8010 <br /> 8015 <br /> Sample Disposal ALYSES REQUESTED ooz'oMod <br /> (check one) Level of QC V 'I ❑2 ❑3 ❑4 ❑5 ❑6A 8021 <br /> (see Side 2) ❑6B E]6C [—]6D ❑ 6E ❑7 Write to 8080 <br /> Laboratory Standard Analysts Method )� 8150 <br /> 8150 <br /> 8240 <br /> ❑ Other SAMPLE INFORMATION a3 0 <br /> Description O Q \ Acidity <br /> P Containers 0 � Alkalinity <br /> FOR LABORATORY USF ONLY 11 `� BTEx <br /> Sample ID Matrix Pres Chloride <br /> Ub ID Number Date Time Locator Depth # Type Type Type TAT o� CLP (see Side 2) <br /> COD <br /> 1 7 — Color <br /> Conductivity <br /> Corrosrvoy <br /> 2 <br /> Z C Cyanide <br /> 3 Flashpoint <br /> Fluoride <br /> General Mineral <br /> 4 , Heli Chrorruum <br /> Ion Balance <br /> 5 �,(/� �(�(� C Melals(wnlespealic <br /> 6 s L metal a method 1)• <br /> 17 Halals 6010 <br /> Halals PP <br /> 7 S Metals Tele 22 <br /> TTLC Level <br /> 8z, �7 STLC Level <br /> u (see Side 2) <br /> 9 Nitrate <br /> Nerve <br /> I B odor <br /> org Lead <br /> Org Mercury <br /> Special Instructions/Comments Percent Moisture <br /> Pc Container Types A=1 Liter Amber TAT(Analytical Turn Around Time) Percent Solid <br /> B=Brass Tube C=Cassette 1 =24 hours 2=48 hours Perchlorate <br /> G--Glass Jar P=Polyethylene 3=I week 4=2 weeks Phos atrn <br /> 0--Other V=Voa Vial 0=Other Phosphorus <br /> Sulfate <br /> Sulfides <br /> Ic r n�C[ SEND DOCUMENTATION AND RES LTS T Zck��, TCLP <br /> FOR LABORATORY USE ONLY Sample Condition Upvn Receipt n+ S voa <br /> wy"roTSemrvoa <br /> jectManager/Office ( metals <br /> ElClient Name MS Pesticide <br /> Total Hardness <br /> Company Total Dot ds <br /> TPHrG <br /> Address TSS <br /> Turbidity <br /> Phone FAX Specify Total or Dissolved <br />