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see <br /> WE L 4080-Pike Lane C'r- .IN-OFCUSTODY RECORD <br /> Concord,CA 94520 800-544-3422 qp ate°" AND ANALYSIS REQUESTa� ��- 5925 Ct1STC11s/ <br /> BQQ 423 7143( in <br /> RECORD <br /> r 4 v 1!O 4 W.4.l l 415-685.7852 side CA)IA600-10.115. 14= ANALYSIS REOUEST <br /> Project Manager. Phone : <br /> 'T E 4! 4 C- FAX 1: u ¢ In ° ❑ <br /> Address: P o 0 <br /> T T Site location: 4� � ❑ ' ❑ <br /> Cr 1 _C oiltor�, 9110 lifer toe Road w _ °_ ❑ ° ❑ ❑ a �, '' 1E <br /> Pro(ecl Number. - � ° r—Pr m $ c c n N = ° x m # <br /> Project Name: t N �; n + } D o ¢ a <br /> '103 475 2894 . 03 @ ❑ � ya m cnrna ❑ ate �► <br /> 1 attest that the proper field sampling Sampler Name Print): o Q m ❑ V <br /> 17 <br /> procedures were used during the collection ❑ e ; 2 'i g ❑ n <br /> of these samples. �0 g 4tp g ,� m +� ® c R o <br /> r r a ❑ ❑ a ❑ ❑ a O ? d <br /> Field 5oura0 GTEL Ma x• Method Sam m $ ° r E $ C v a a N <br /> Sample of z Preserred ❑ I m w ,� m CO „ W y 19 9d a <br /> p Lab# C O O ; N N ❑ b <br /> ID Semple (Lab ue• a o '� <br /> Uj <br /> only) i Q a p. ft o a ❑ - '_° o ❑ ❑ ❑ o ❑ ❑ m E R a <br /> O 1wr ow S dj .zW o ° m m >2 a ^ o <br /> +U. 3 udi a N O i x 2 U Z O D i= = o ° b a s < a a a � t '- <br /> a a v a p a a a s 0. a a: ¢ Q <br /> r]—! L <br /> r- � �- r- w w w w w w w � w .,e U U <br /> 92 Z <br /> 2 oSQ p <br /> 9ib0 S2o <br /> Q <br /> SPECIAL HANDLING <br /> SPECIAL DETECTION LIMITS(Specify) REMARKS: �R(rt' <br /> za HOURS❑ a <br /> EXPEDITED 48 Hours ❑ l�jraSt twr1wse Siff odJrrif <br /> SEVEN DAY ❑ G 14 i a <br /> OTHER (#)BUSINESS DAYS Q a <br /> L O <br /> • QA/UC CLP Level C7 Blue Level❑ SPECIAL REPORTING REQUIREMENTS Lori Use Only `-' <br /> FAX❑ Y Storaga Location <br /> (Specify) <br /> . v <br /> r <br /> Lot#: Work Order st: <br /> Q <br />