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� �� JV.LU r <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> 510 fi85-7852 Wr'- <br /> 1NVIRONM Al �{t �,U10RArOR111 INC. 800 423-7143 t ,�t ,3• �,,,,.' � 1���,1 . x r k. :�« <br /> Company Name Phone N <br /> V ' Col'xar FAX N, ❑ ° e ❑ <br /> Company Addresstt�� Site location S��[ O�} C L �0 13 1313 01 <br /> x *d0 C) a <br /> Project Manager Cilent Project ID (N) win co <br /> 11�AA y m ❑ N <br /> Satr~dgi. L ndse NAME L b 0 9 0 ❑ z z ❑ 0 ❑ a <br /> 1 attest that the proper field sampling Sampler Name(Print) a ❑ ❑ 0 0 ❑ ❑ $ ❑ <br /> procedures were used during the collection ❑ p ❑ m O <br /> of these samples ,(�}�`A Zt 1 CS� G ❑ o � .» � a � 52 � � � a 0 1 L <br /> Matrix rz; Meth�od Sampling <br /> anplirg m x -x � � o�8' aa Sa a a❑� &Ial!l 13a Qms ❑ <br /> m Preserved <br /> 13Field GTEL T �a <br /> u <br /> �❑ <br /> C A ,Sample Lab # U' mw ID Lab use only) w <br /> a9 = zx o <br /> an8 = o � � <br /> ❑ <br /> uJi <br /> ❑ .� <br /> _ F <br /> FAL8 3•oo <br /> 96 ` ,w <br /> �►34 zw k 13: <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS P aF <br /> Prlollly(24 hr) ❑ GTEL Contact <br /> Expedited(48 hr) ❑ QuotelContract N <br /> 7 Business Days ❑ Conflrmatlon N <br /> Other pp N SPECIAL REPORTING REOUIREMENTS Lab Use Only Lot N Storage Locatio <br /> Business Das ❑ <br /> OA!QC LEVEL C <br /> �� <br /> BLUE❑ CLP❑ OTHER FAX Work Order N <br /> Relinquished by Samp r Date gTime Received by A <br /> 71;h-9 <br /> CUSTODY Relinquis ed by Date Time Received by <br /> RECORD Relinquished by Date Time Ra y Laboratory <br /> Rnv 7191 -- ----- -- - --- <br />