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ft IcCaCYi k�edl Analytical,. innc. <br />O1534 <br />CHAIN OF CUSTODY RECORD <br />Willow Pass Rd. / Pittsburg, CA 94565-1701 <br />www.mccampbell.com / main@mccampbell.com1 <br />1 <br />TURN AROUND TIME: RUSH Ja I DAY Q 2 DAY ❑ 3 DAY (a 5 DAY <br />GeoTracker EDF UPDF LllD ❑Write On (DW) EQuIS 10 DAY <br />Telephone: (877) 252-9262 / Fax: (925) 252-9269 01 <br />"J" <br />Effluent Sample Requiring flag [a UST Clean Up Fund Project ❑; Claim # <br />Report To: Kiersten Iloey Bill To: GHD —Kiersten Hoe <br />Anal <br />sis Request <br />Company: GDH <br />c7 <br />i <br />°" <br />e <br />ffi <br />v <br />c <br />i~ <br />° <br />��'• <br />dcJQ <br />!✓ <br />e <br />c <br />O <br />5900 Hollis St, Suite A, Emeryville, CA 94608 <br />Tete: 510 420-3347 E-Mail: Klersten.hoe hd.com <br />Project #: 11103471 Project Name: Chevron 201383u <br />Project Location: 1930 W. 11°i St.1mg CA Purchase Order# 34004571 <br />Sampler Si nature: <br />SAMPLING <br />MATRIX <br />METHOD <br />PRESERVED <br />S'o <br />3 <br />6 <br />SAMPLE ID <br />Location! <br />Field Point9 <br />3 <br />a <br />3 <br />►. <br />ffi <br />s <br />a <br />° <br />in <br />0O <br />N <br />r <br />Name <br />Date <br />Time <br />2 <br />.3 <br />a. <br />G <br />NN <br />" <br />� <br />-n <br />iz .n <br />O <br />V <br />E <br />8 <br />���� <br />4 <br />���� <br />V`✓ <br />6. <br />a <br />W <br />o• <br />.31 <br />o� <br />1 <br />9 <br />%n <br />Q <br />e <br />Q <br />d <br />ad <br />In <br />all. <br />In <br />m <br />g P, <br />Te - f <br />i [14 <br />11:30 <br />4 <br />1 <br />2 <br />f v <br />' 40 <br />0 <br />jb.v� <br />"MAIclients MUSTdisclose any dangerous chemicals known to by present In their submitted samples In concentrations that may cause Immediate harm or serious future health endangerment as a red. open at sam le <br />handling by MAI staff. Non-disclosure Incurs an immediate $250 surcharge and the client Is subject to full legal nabttity for harm suffered. Thank you for your understanding and for allowing us to work s. <br />•" II metals are requested for water sam les and the water type Is not s ecltted on the chain of custody, then MAI will default to metals by E200.8. <br />Relinquished By: <br />Da e: <br />Time: <br />Rec d By: <br />ICE/t° COMMENTS: WS <br />GOOD CONDITION ` X <br />� <br />HEAD SPACE ABSENT <br />DECHLORINATED IN LAB ✓ YL <br />Relinquished By: <br />Time: <br />By. <br />ate: <br />Bpfr,ed <br />APPROPRIATE CONTAINERS <br />PRESERVED IN LAB <br />O <br />VOAS O&G METALS OTHER HAZARDOUS: <br />Relinquished By: <br />Date: <br />Time: <br />Received By: <br />PRESERVATION pH<2 <br />P <br />Page 15 of 17 <br />