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Chain-of-Custody Record and Analytic Instructions Page---/—of B00065 <br /> Send all results and Invoices to <br /> _.._.. ._ ..-._....... ........ Field Log Book#(COC#) Release# <br /> M. Heaton, LLNL Acct. # ���U'�5' Sampling Re uest# <br /> (please fill in and circle) P g <br /> Attn: ORAD Data Management Team L-633Analytical Laboratory Name CLS <br /> Lawrence Livermore National Laboratory Analytical Laboratory Log# <br /> P.O. Box 808, Livermore,CA 94550 <br /> Analysis &TurnarQpnd Additional Instructions to Lab <br /> ,�j •- <br /> Also Fax copies to: X4 R(c-, t' 44/Or� i ' � <br /> Fax# - Z`7�7(� Required 1 —AWS <br /> Project Name: Ttf ?_? "J _,/( <br /> Sampled By Sampler's Employer: 6-ai c <br /> 2 Grid/Sample Matrix/Type #of u <br /> V <br /> � � •�; <br /> Identification Date/Time Container/Type 3 Cont. Area Remarks <br /> C)nic' , <br /> 'T--( 2!I -/0,6 T <br /> 721c0 Lo rk c► -vz <br /> ,77 <br /> Signature Company Time Date 1. N=normal turnaround, F= I-week turnaround <br /> Relinquished by , e' Z 1� R=24-hour turnaround•H=Hold do not analyze unless requested <br /> Received by /� <br /> � Z 2. Sample Matrix Codes:See list on back of pink copy <br /> Relinquished h / G j ss 3. C(miainer type axles: V=VOA Bottle,P=Plastic Bottle, <br /> Received bX ) (_=Glass Bottle,T=Brass'rube, <br /> �� `11 B=Bag,S=Stainless Steel Tube, <br /> Relinquished by 0=Other(specify under remarks) <br /> Inlernal Use Only <br /> Received by (,`. _.__.__....._.__..__,.._..__. <br /> White: Laboratory return to ORAD P <br /> 12cvisi m .t. Yellow: Anahtical I.ah Pink:ti:unplcr luaccs isith OIL\D <br /> r 1 t X111)KAI) Attn.Data Management'1'emn 1,-633 Attn.ORAD Mita Nlana}rmenl Team L-633 <br />