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3102.9�W.Iq f Page,L of <br /> Chain of Gustodv Record <br /> On-site Time Tem <br /> Protect Name 11194 GW Monitoring oto site Time Tem <br /> Bl" l3UGETN1 CO Portfolto: Retail Sk Conditions <br /> �n`�,cilp-7 1311 Laboratory Contract Nrtunber AtlantlL Ruh-Geld Co IMMUeorologicalEvcrits <br /> Date Requested Due Date(inmlddl)y) °i ew�ou,a Vv`trid S eed !mow Direction We-4i <br /> Send To BP/GEM Facility No 11194Consultant/Contractor URS <br /> Lab Name SEQUOIABP/GEM Faulit y Address 2375 TRACY BLVD TRACY, CA Address 2870 Gateway Oaks Dr, Ste 300 <br /> Lab Address 1455 N McDowell Blvd Suite D Site ID No 11194 Sacramento, CA 95833 <br /> Petaluma, CA 94954 Site Lat/Lon -mail rDD dense yee@ursCOT com <br /> 'alifornia Global ID# T0607700011Consultant/Contractor ProJUA No <br /> Lab PM An elect CanBP/GEM PM Contact PAUL SUPPLE Consultant Tele/Fax 916-679-2387/916-679-2900 <br /> 1 etc/fax 707-792-18651707-792-0342 ]Address P 0 Box 6549 Consultant/Contractor PM VERN E <br /> Re art 1 e& C Leve l Send EDF Reports Mora a, CA 94570 Imoi"to Consultant/Gontractor dqp,26M irdc unc) <br /> I3P/GEM Account No 400-6-2 1 1 24 TeleJFax 925-299-88911925-299-8872IPP/GEM Work Release No <br /> ab Bottle Order No Matrix Preservatives Requested Analysis <br /> w <br /> to <br /> u `N° U1 m <br /> LO <br /> o � n A <br /> Item No Sample Description Time -0 U Laboratory No n 0° 0 0 Q ¢ Sample CommenPoint ts ong and <br /> W <br /> m v o 11 <br /> ri 3 rn d <br /> 1 Aµw-'�.. 1625 I W-31C)L9L G I I I X I X <br /> 2 A w►w-I 13KO x /L n <br /> 3 t l 10 G <br /> 4 <br /> 5 mow--! ItSS <br /> 6 A VAW-reb K X <br /> 7 AtwW'ti I L*50 <br /> 8 mvo-'S I-LO <br /> 9 A+`i*NW—'s i W Ssj G <br /> 10 I�LvJ S l�l'LS L Irp X X <br /> Sampler's Name ,A/ CA0.4I-1itAO Relinquished13 /Affhation Date fine ce46 B /Affiliation Date ime <br /> Salm in ler's Coan [ <br /> Shipment Date 03, <br /> rShnment Methodent Trackin Nol instructions Address Invoice to BP/GEM but send to URS for approval -If total lead value is>50 ana vie for lead by STLC,value is>5 an vze for lRUN 8260 ANALYTES IN ONE BATCH ANALYSISdy Seals In Plate Yes No__ Temperature Blank Yes No Cooler Temperature on Receipt IC Trip Blank Yes No <br /> Distribution Wfiat,Copt L iborawr)f Yew;%Cop} BP;t3EM /Pifer Cup} Consultain/Conlracior BP COC Rev 1 M2 <br />