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LUNCURDr CA 54520 +Af#UANALWOO*tV=WWS:00 <br /> tv " 510) 685-7852 . <br /> ftf� �,�rotr�toat , trrc 800)423.7143 !1 <br /> Company NPhone#. 0 <br /> FAX ° © 1 ° <br /> Company Address* Site f ationn m <br /> tW 07 <br /> E 13 ❑ ° <br /> Project Ma age Client Pro ect ID # 0 + ❑ <br /> g { }0Zo301Z11�30S� W U ° <br /> NAM .lTt*�-1 8 © ° ° z z 0 ° p ❑ ° <br /> M 13 <br /> 1 attest that the proper field sampling ampler Nems(Print) ° C3 138 <br /> procedures were used during the collection 0 ° ❑ ° a <br /> of these samples ❑ G 0 s <br /> Method O $ O o ° <br /> Matrix Preserved Sampling ❑ p $ $ ° 8 ° o 13Field GTEL ° F cc 0 �. ❑ <br /> 0 ° ° <br /> ID (Lab use only) 3 a w mS <br /> 8 UL ° <br /> ac Oa W a �ga a aam Xl0. g a <br /> O�, <br /> R °0 O S I S F� WhN swSample Lab # <br /> '}^ r <br /> p1 `� kt ll OKIZ <br /> Zr <br /> � Z.Z <br /> z � <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKSs <br /> 6AG <br /> S 0A) rG eG <br /> S $Priority(24 hr) ❑ GTEL Contact 3'� <br /> Expedited(4e hr) ❑ Ouote/Contract# <br /> 7 Business Days ❑ Confirmation N <br /> Other Co SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot N Storage Location <br /> Business Days ❑ <br /> QA 101 LEVEL <br /> j BLUE❑ CLP❑ OTHE FAX❑ Work Order# -50 <br /> 54 <br /> Roll q ishe by Sampler ate Time Received by <br /> A11 - <br /> CUSTODY Reli s e y' Date Time Received by <br /> RECORD Relinquished by Date Time Recelved by Laboratory' <br /> 00 Waybill# <br />