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06Paged of <br /> c� Chain of Custody R lyd 2 Tem ` <br /> On-site Time <br /> Project Name 11194 GW Monitoring Off-site Time Tem <br /> �' BP BL'/GENT CO Pot ttoho Atlantic Ridifield Co. Sky Conditions &64LAfk <br /> IBP Laboratot) Coll 6,11-t Number. 461000 Mi teorolo tcal Events <br /> Requested Due Date(nim/ddlyo ^ 56r(�i�/ Ind S eed L3ireC[ign <br /> Send To BP/GEN1 FdUlay No 11194 onsultant/Contractor URS <br /> Lab Name Sequoia Petaluma BPiGEM Facility Address 2375 TRACY BLVD ,TRACY CA Address 2870 Gateway Oaks Dr, Ste 300 <br /> ab Addmss 1455N McDowell Blvd Suite D Site 1D No 11194 Sacramento, CA 95833 <br /> Petaluma, CA 94954 Site Lat/Lon -mail EDD denise_yee@urscorp com <br /> California Global ID# T0607700011 onsultant(ContractorProject No <br /> Lab PM Mike GilesBP/GEM PM Contact PAUL SUPPLE Consultant Tele/Fax 916-679-20001916-679-2900 <br /> f601'ax 707-792-1865/707-792-0342 Address P O Box 6549 Consultant/Contractor PM Jeff Broo <br /> Report I ypc&QC Level Level 1 Report&EDF if EDF Required) Mora a, CA 94570 nvoiee to ConsultantiContraLtor o BP/GEM ircle ani. <br /> BPIGENI account No 400-6-21124Tele/Fix 925-299-8891/925-299-8872 P/GEM Work Release No <br /> Lab Bottle Ordcr No Matrix Preservatives Requested Analysis <br /> w <br /> n m <br /> o <br /> Item a g m Sample Point Lat/Lon <br /> andSample Description Laboratory No ©No 00 <br /> F- <br /> 0 E Comments <br /> L 4 <br /> a c Q z <br /> w- ani -b l �C X OOLERCL To I $EALS INTAC I <br /> 2NOTiNTACOP <br /> KW• �' X <br /> d l jQ X xX OC LEF TE 4PE ' TL RI, <br /> 5 MW' K <br /> ate,- I40 ,� fC <br /> 7 L <br /> to <br /> Sam let's Name /-- Relin ulslie /Afli iron Date ime ted By/Affiliation <br /> ate ime <br /> Smn let'sCotn�pan?� tAIAJF -Z-r31' c laSS �f-e'G, -z_a�- Or <br /> Sht trent Date <br /> Shipment Method C ' xt 4-) b 0� <br /> ISht mens Tracking No <br /> Special tnstructions Address Invoice to DP/CEM but send to URS for approval <br /> RUN 826 ANALYTES IN ONE BATCH ANALYSIS <br /> C:ustQd) Seats In Place Y es V No T emperature Blank Yes ',-�o Cooler Temperature on Receipt of/C Trip Blank Yes o <br /> Dwribtaton Alii(.Coln Laboratur3 (1 diva (.up} 8P(GEM /Firm Cop3 ConwltUt/CuniraCtor SP COC Rev 3 12115103 <br />