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ACC -,` (0 =¢l ? <br /> Lawrence Livermore Page Z- of—Z----pages <br /> National LaboratoryChain-of-Custody Record <br /> and Anal he Instructions Chain-of-Custody Doc. Number U Pt - 09 3 <br /> ENVIRONMENTAL RESTORATION Y <br /> DIVISION,L-528 Analytical Laboratory Log Number <br /> P.O. Boa 808,Livermore,California 94550 Analytical Laboratory Name C LR Y To 0 LAB S <br /> Analysis Requestor/Data Recipient(circle one): Analysis&Turnaround <br /> W.Isherwood-t W.Isherwood-2 W.Isherwood-3 A.Lamarre- A.Lamarre-2 A.LamarYe-3 Required' <br /> cc:Dtesen cc:Mallon cc:Boegel cc: cc:Henry cc:Boegel <br /> e0eI.�NJ s. cvP[ANaroti �} <br /> Sampled By Company Name �► �� <br /> Sample/ Number <br /> Site and Technical Sampling Container of Analyze/ Q o Remarks <br /> Information Codes Type2 Containers Hold3 a��� m <br /> V850- w) - 1-4-3o' °1-Z 8-90 s° ���t I P N N Sa. c..- <br /> U8So-D ul- I - 1 ' 10 1 P N 1. <br /> V956-DI VI - 13 - Z3' " I P N N <br /> ueSO-Uiul - 13 — 33 N <br /> oITI� UBso - DI VI - 1`I - Z4' " 1 P N N <br /> U 850-Diu l - 14 - Zq' I P N N <br /> Vaso -Doul - ILI - 34' I P A/ nQr!1 <br /> U $s®-Dlvl - 14 - 3cl' " I P` t4 <br /> �l <br /> 1)gSO- DIV1 - 14 <br /> Si nature Com an Date Time EtNI MENTAL('/� <br /> RelirWished by/ y„ j a', „ S��_ -ld-7�� ; ,, I. N=Normal Turnaround,F. I-WeekF# AL�T i . <br /> - R=24-Hour Turnaround. ilyV. <br /> Received by�_ i e 1�^ j`: L,V L [(_H-1l J } <br /> 2. Sample Type Codes: W=Water,S=Soil, VPR=Vapor, <br /> i 0=Other(specify). <br /> Container Type Codes: V=VOA Bottle,P=Plastic Bottle, <br /> Received by l �ice- s _�, G=Glass Bottle,T=Brass Tube, B=Bag, <br /> Relitxptished by a u�� O=Other(specify). <br /> Received by rJG �'.�� 3.Analyze/Hold:A=Analyze,HOLD(spell out) <br /> DO NOT ANALYZE UNLESS REQUESTED. <br /> Revision 1.7,5 Oct 89 _�' y �i/�' l�,a� / / '� - ' ?� �// <br /> Pink: Leave with FRD, Yellow : Analytical Lab White : Return to ERD <br /> �c << elvt�� �•� T(( r�f� �.�� I ?'� qU 'M titi <br />