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S <br /> 1 1112:1111111:1511, <br /> G'TE 4060-Pike Lane CHk..eOFCUSTODYR-CORD <br /> Concord,CA 94520 800.544.3422(In CA) AND ANALYSIS REQUEST 72- 4025 CI.MDYrvEGORD , <br /> I N y I IF V N 4 r N 7'1 415-895-7852 800-423-7143(Outside CA) <br /> ttttttad iAe0vAror11e. INC ANALYSIS REQUEST <br /> Project Manager. Phone#: 0 ❑ <br /> b tja�u� ❑ t7 <br /> (, FAX alt: � � cEf <br /> Address Sit IgqcCalio n: g d <br /> / {{ tto 1,orrgtoq ❑ " C] <br /> CoNC-0a? T L :i_.0 PT-0N w m ❑ ❑ ❑ m E) N � CI <br /> Pro ect Number a C. ° �" '� _ < 0 m . <br /> Project Name: 6 �; ;, o ° } +V 13 13 S <br /> / 7 .0 o✓r �r9 s�{K"•a�V 3 m D Qf c o z z ' m D <br /> I attest that the proper field sampling Sampler Name(Print): © o ❑ u �' o ° ❑ c <br /> Procedures were used during the collection ri ❑ $ <br /> of these samples. ❑ 01 y a < v <br /> 0 0Field Source GTEL w Ma(;Ix preserved Samplin 8 p v m e o 0 0 0 11 ❑ <br /> Sample of Lab# 05 A 9 o 0 0 Mfg n a " ❑ <br /> ID Sample (Lab use F Li y C o p p p p p p o P ° e ' <br /> only) z a '0 a . ¢ o Q — m 0 a < 0 � o 6UJ <br /> U J ax � 3 to w z 19 <br /> T ' w w ° m m m u m x0 a R X '� <br /> o_ 1 r D z p t ¢ ut Y o < < < < < < ¢ 1 <br /> kBPw`!� * 30¢of o i x 2 U ZO to r= a t° F° w w r4u w w w w w U ¢ <br /> r L� Ixls <br /> CC <br /> ld <br /> l- I- a <br /> ni w� i• y - `' <br /> l�dnfwr i ly <br /> 1W l rJ F % <br /> C/ _ ILiI <br /> i 2 <br /> 1a <br /> 24HOURS❑ IALHANDLING SPECIAL DETECTION LIMITS(Specify) REMARKS: �� / 0"C- g <br /> Nt <br /> EXPEDITED 48 Ho6rs ❑ �+ E <br /> SEVEN DAY ❑ � a <br /> OTHER (#]BUSINESS DAYS v <br /> OA/OC CLP Level❑ Blue Level❑ SPECIAL REPORTING _ c <br /> REQUIREMENTS Lab Use Only <br /> FAX❑ (SReciry) on Storage Location 3 <br /> .�Lot it: Work Order tt: c � <br /> ¢ <br /> -4 <br /> I <br />