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KIFF Davi 2nd Street,Suite 300 <br /> Davis,CA 35616 <br /> Analytical LLC Lab: 530.297.4800 SRG#/Lab No. Page of J_ <br /> Fax: 530.297.4802 <br /> Pro' t C0.ont (Har copy or PDF Toy California EDF Report? <br /> ec ❑Yes <br /> jfi 6_ �C r Chain-of-Custody Record and Analysis Request <br /> Company/Address: Sampling Company Log Code: Analysis Request TAT <br /> P on #: Fax#: Global ID: o El°1l6 372-1+13'1Q 12 hr <br /> Project#: P.O.#: EDF Deliverable To(Email Address): m ❑ O <br /> 2l N. of �nTAy Au-Ac <br /> LORGW E-KItiHl,cowt m w m m m <br /> Project Na/me: `1 Sam 5 ature: m o o C, a o 24 hr <br /> 22 I C I 0.f ��t"a4�� w o o a 1n N �_ m ❑ <br /> Project Address: Sam ling Container Preservative Matrix o cu a 10 w — w o a -' <br /> a ® in m � �a - a m w o 48 hr o <br /> m m m N d d U C LLL VUJ a U ll <br /> t0 (p NCM N Q W w .Y .Y _w D a � ❑ <br /> Q M a) m a m m v w co m O w <br /> O a a Q "� rt d > 2 m <br /> m o 72 hr <br /> 7 y w w w m m 2 O O m <br /> m ` w X co rn n m m mE > <br /> p — FJ z m m Fa o <br /> Date p 0ao wSam le Designation O o Z > > > F- <br /> --t H <br /> D1 - 1 t <br /> �1- 1 !l -so <br /> oz <br /> D3 - 1 IZ3� <br /> 03 <br /> Reli u hed by: Date Time Received by: Remarks: <br /> Relinquish by: Date Time Received by: <br /> Bill to <br /> Relinquished by: Date Time Received by Laboratory: <br /> �l , For Lab Use Only: Sample Receipt <br /> I Q� Temp°C Initials Date Time Therm.ID k C i—I P,-" <br /> %�7'� //J._,�►Y4.j��� ( I I s'?- Tie- Yes / No <br /> Distribution. White-Lab;Pink-Originator <br /> Rev: 051805 <br />