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cj vsg�s <br />Laboratory: <br />Network/Group: rglo kS G i►"t <br />Sampler:/. r__ .. _ <br />LLNL Analyst: 9L5,iwz3 67-6 <br />Sample Identifier <br />Sample <br />Date &Time <br />7 / 114— Z� c� I - .T7� <br />2� <br />2 <br />Prelim. TAT: 7jq AAS' <br />3 <br />r <br />4 <br />5 <br />6 <br />7 <br />Re s d y S per: <br />DateReceive <br />Qui1,1737) <br />8 <br />Date Time <br />l % <br />9 <br />10 <br />aeZ 0v <br />«y o nit <br />11 <br />12 <br />Cita <br />Relinquished by Co o <br />13 <br />Receive at Lab tory: <br />Date/Tltpe <br />14 <br />15 <br />Data quished m Lab: <br />Date _ <br />144 <br />Release Number or._ pica +, T Signature. <br />DISPOSITION OF COPIES aft i natures <br />Goldenrod: Returned to TSG DMP by samp er witK courier signature or airbill no <br />Pink: Signed and returned to TSG DMP by laboratory upon receipt of samples. <br />Canary: Retained by laboratory. <br />Green:Retained and Ned by analyst. <br />White : Archived with data by TSG DMT. <br />ALL SIGNATURES MUST BE MADE ON WHITE COPY <br />ORAD: WGMG/TAMM/TSG/EOG <br />Lawrence Livermore National Laboratory <br />P.O. Box 808, L-629 <br />Livermore, CA 94551 <br />Form QAP-8 <br />Rev. 12 <br />Nov 2001 <br />1 <br />10919,_ <br />Chain -of -Custody Record ®ORAD/TSG EITAMM (air only) <br />ORAD/EOG Other page _ of L <br />Rectuested Analvsis Codes and # Containers per Analysis 7Analytical Lab;:Use Only <br />J <br />12 <br />tv <br />Fax to: <br />©©n <br />REMARKS <br />Prelim. TAT: 7jq AAS' <br />r <br />TAT: <br />Re s d y S per: <br />DateReceive <br />Qui1,1737) <br />y: � '-� <br />/ <br />Date Time <br />l % <br />e s F- <br />aeZ 0v <br />«y o nit <br />as =oQ <br />Cita <br />Relinquished by Co o <br />Date/Tim <br />Receive at Lab tory: <br />Date/Tltpe <br />Data quished m Lab: <br />Date _ <br />144 <br />Data received by LLNL Analyst: <br />Date <br />Data relinquished by LLNL Analyst: Date Data received by Data Management: Date <br />