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r j <br /> 10-16 Clive Drive,Suite 916.753-9500 'f CHAIN-OF-CUSTODY RECORD AND ANALYSIS REQUEST <br /> Wesiem fnsiromnmm - Davis,CA 95616 FAX#:916-753.6091 r+ <br /> sc�enceii rerAnaiogy LAB#:916.757-4650 1 Q <br /> Project Manager: h Phone#: <br /> l 9 avid ANALYSIS REQUEST TAT <br /> tick 11 acs —Ic-,, S72 .1Y-3 )I <br /> Ccmpany/Address: FAX#: w.r r.i�l � <br /> �OSbs9---1 . 3� Z _q��� ?oraLI�1 <br /> LL <br /> 3 <br /> Project Number: P.O.#: Project Name: 3 j L <br /> l t , o 2-- LWgyp P>� <br /> O W A y N L Y <br /> QO W m <br /> fl W O q C � 'J m_ [V <br /> Project Location: Sampler Sign tune: a n h U a a UJ <br /> N O O N w <br /> U t0 N d w LU <br /> d a "4 d N Z U N V7 <br /> Container Method Matrix o " m b m a o o b a o 0 w <br /> Sampling Preserved p H `� o o N " — a N rr o a <br /> Sample o = � � ^6 '� � an d m � � � � � r. 6 Q a �; � Q <br /> w <br /> to U tL ° A O O o o 'u N N z i CL n ! <br /> l� GATE TIME w ¢ h W W x m O _ '� o cc m ;a m we m om ¢ `� U i= w Z <br /> G w O w z 4 w w 2 m Q Q ¢ Q ¢ ¢ Q ¢ o Q Q ¢ i� ¢ <br /> O w C5 a v z O O F r a. a d m d a a 4 a 4. a w x t- <br /> y in CL x x r? z w m m >- r 0 www w w m w 0 s U w r3 x w rn <br /> t $ Z ` f 3; <br /> S 3'.0 <br /> s D fI <br /> S-7 '1 t_ <br /> It I <br /> C? <br /> slo Z' 8 . <br /> Relinquished b : Date Time eceived b : Remarks: �� �' !! <br /> R <br /> Y Y Pa-1111t- �iriAat-- <br /> Sol�� c �•�- - u� sf. <br /> elinquished byate Time Aec by: r <br /> ' d I <br /> P/ /. 3as 3 r tf <br /> Refin fished by Date Time Received by Laboratory: Bill To: <br /> A 1L <br /> PL- It q-? <br />