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Amok <br /> 4080 PIKE. LANE, SUITE C MAIN-OF-CUSTODY RECORD <br /> PGTEL CONCOaD, CA 91520 � <br /> AND ANALYSIS REQUEST 109-7 <br /> (800) 423 7143 <br /> f•rer•ro•n .[ <br /> f <br /> Company dame Phone d <br /> FAX M O ❑ m ❑ <br /> Company Address ` Site Location m r x <br /> f '3 ❑ ❑ ❑ 0 N Q O <br /> Prolecl Manager 0 Client Prolecl ID [H) Ln N O L❑/ <br /> L D7 6Z��bo)33 a Q m rn i 4 Q <br /> I El <br /> X10 v o ❑ © ❑ ❑ z z ❑ ° ❑ ^ <br /> I ailesl that the proper field sampling Sampler Name(Print) ❑ in ❑ ❑ m E q ❑ Q <br /> i procedures were used during the z_ N ; e ❑ ❑ a - g vy M I] <br /> collection of Iheso samples Q ,e C Q c7 y ❑ o N ❑ © v }- w C7 a° � ^ `s <br /> o +n , O o N a a � ro ❑ a <br /> Matrix Method Sampling Q p �' a s 00 a o M o ° o 13 ^ <br /> Fleld GTEL w Preserved to a N ❑ ❑ �' w w w ❑ a 8 ❑ <br /> Sample Lab f a �, ❑_ ❑ ❑ u A � N <br /> ID (Lab USC} O _r j O z s O Wa w3 to w XX � c ¢ a vii $S fCY ro m O a "r o <br /> i l Only J U 4 O J Q F- U Z N w na Q F j� y. a co O Q d 0. a 0. 0. a a JQ v ro <br /> ro a <br /> O x x x V a� 0- o r m m x x O F w w w w w w w w w ►V w U °; O U <br /> 1 A I �.` , '3,. , } ,- ' 'H i` V •�{ '; f, Q 17 = t '� ,;+ f r• 4 <br /> G �1 • /�� : d` <br /> woo <br /> _}Il_+ fL11 _ -�5 1 <br /> l��y`.L�LL= 1 1 ~~ F /_L r 'y F '; "} 4- y <br /> 11—L I`7 A N # _ <br /> r i s <br /> N_L1 ,10_ --- 3 X <br /> Ix r'w' <br /> _ <br /> 1-'►- 1- r + -i , r' l{ t „5 t f q q `n I s II r , t d. I <br /> fi <br /> in <br /> t�°{2 s} i t + i ttW 1 It , , <br /> - SI- Speclal Handling SPECIAL DETECTION LIMITS REMARKS <br /> Pridnty{24 hr) ❑ GTEL Contact t kw.a- F <br /> Erpodrled 148 hr) ❑ Ou01e1COnlraCt N ' r, <br /> + 5 <br /> 7 Busineem Nys L] <br /> (ht�r Canfirmallon R <br /> P O M SPECIAL REPORTIN REOUIREMENTSI, Lab Use Only 9 Lot R Storage Liauon <br /> Business pays [J � r . <br /> 0A10C Level k, <br /> Blue❑ Cil'❑ Oihar❑ FAx❑ Work Order N <br /> Rell qui ed by",4ta ler Date Time Received by <br /> CUSTODY 9 iZ" g• '' 4' <br /> nD 3el*ulshed by Date Time Rectrved by <br /> RE M O <br /> rl Rbllnqulshed by Dale Time Received by Laboratory <br /> p <br /> Waybill tr <br />