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nerica San Francisco TestAtme'ca <br /> rry Lane 2 f Cham of Custody Record Till,4e saje04,,ttg0NMCMTALTVsrrHcz <br /> n, CA 94566 ) f u <br /> ?5)484-1919 Fax(925)600-3002 Lap PM: Carrier Tracking Na(61: COC N 1' <br /> Sampler. 720-11430.1 <br /> Sharma,Dimple page: <br /> nformation Sub Contract Lab) E-Mau: page 1 of 1 <br /> ,G: phone• dimple.shamta@lestameflcalnC.COM <br /> Job#: <br /> Receiving720-33917-1 <br /> Analysis Requested <br /> preservation Codes: <br /> ps <br /> Due Date Requested: A-HCL M-Hexane <br /> 3m Pitt Way, 312912011 U O-Ase-NaOH N-None <br /> TAT Requested(days): C-Zn Acetate t4a02 <br /> Elh D-Nitric Acid p-Na204S <br /> V E•NaKSO4 O-Na2S03 <br /> O F-McOH R-N92S2SO3 <br /> v G-Amchlor S-H2SO4 <br /> H-AscofbicAcid T-TSPDodscahydrate <br /> 38 PO 9: V 1-Ice U-Acetone <br /> -5245(Tel) J- water v-MCAD <br /> WO#: + a' z � K-EEDTA W-ph 4-S <br /> )a p L-EDA z-oiher(specify) <br /> Projec <br /> t. <br /> 200 2 <br /> 7 <br /> ime: r c <br /> 72003299 04' O g Other: <br /> Pracy Yard <br /> ssown: <br /> U <br /> Sample Matrixm� � � <br /> El <br /> (WWaur< l O <br /> Type a-.oua, i m <br /> Sample (C-comp, o•W.utlaB, ,,. S eciallnstructionslNote: <br /> e Identification-Client ID Lab ID <br /> Sam le Date Time G= rab ar•n..�.,�•eo- rn y� <br /> 15:45 Water X <br /> WG-2480-TW03-160311(720.33917-1) 3116111 a •1 <br /> 3116111 13'45 Water X <br /> WG-2480-MW15A-160311(720-33917-4) ) <br /> 3116111 15.20 Water X <br /> WG-2480-MW22A-160311(720-33917-5) P Ci <br /> WG-2480-MW26A-160311(720-33917-6) <br /> 3116111 14:35 Water X <br /> 12.55 Water X <br /> WG-2480-MW A-160311 (720-33917-11) <br /> 3!16!11 <br /> Sample Disposal{A fee may be assessed if samples are retained longer than T month) <br /> sible Hazard Identification =Retum To Client E3Disposal By Lab CD Archive For <br /> Non-Hazard Flammable ©Skin Irritant Poison B Unknown Radiolo ical Special lnstructionslQC Requirements: <br /> verable Requested11,11,III,1V,Other(specify) Method of Shlpmenl'. <br /> Data: Time: <br /> )iy Kit Relinquish d hy: Datefrime: Company <br /> e <br /> Comp Received by: <br /> squished by' 7 j r � [ l!� palelPim ' Company <br /> flat Ime: Company Received by: <br /> squished by: D / Company <br /> Oalefrime: Company Rec' d <br /> squished by: <br /> ;ustody Seals insect. aI No <br /> Cooler Temperelur@[s)"G and 0ttler Remarks .T<'}� <br /> Cusiady Se <br /> ,A Yes -6 of 52 04/04/2011 <br />