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'CITY OF STOCKTON MUNICIPAL UTILITIES DEPARTMENT <br /> Custody Transfer Record 1 Lab Analyses Request <br /> Write in shaded areas only 'Page <br /> 5richdni Sarnpl@r IDS , ANALYSES REQUESTED <br /> Bottle <br /> Account# �tepprt t Lot# <br /> rc 5... ... fr 1 <br /> A <br /> Lab ID <br /> Sample Location 1 Description 1 I.D. P Se. Coma o <br /> 'Vol. G Sa. Tine Pres. for <br /> Type Type C Date con. C.L. <br /> lob <br /> I wx . .. ........ .. .. . : ...... . � ::i .:.. .. <br /> s <br /> ETV J_ <br /> S crallnstrucllons :::':'.'.':' :: :: ::•:: <br /> !` f� _?] r to:�' f" ? ._ e t- �i{?,c r +a5 4f _ f r , , r Evidence p les? <br /> I Tape: Present on samples? Y or ki <br /> fz <br /> ::. <br /> v. ::•-�:::;:°, Unbroken on samples? Y or N <br /> Samples were received E god condi ion? or N <br /> Released by Received by Date Time Released by Received by Date Time <br /> EContainer Type: P-Plastic G-Glass A-Amber V-VOA Container Volume: L-Liter G-Gallon P-Priority: 1: 5 working days 2: 10 days .3: 15 days <br /> -S,.Type: W-Water WW-Wastewater S-Sludge X-Other G J C: C-Composite G-Grab 6 M: Cd, Cr,Cu,Ni, Pb,Zn <br /> WHITE-Flle CANARY-Lab 1 PINK- Lab 2 GOLDENROD-Sampler <br /> - rev 07-20-83 TH WP:TAFORiAS:CTR <br />