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C 1885 N.KELLY ROAD NAPA, CA 94558 • (707) 258-4000 Fax (707) 226-1001 LA .ORDER#: <br /> A _ SAMPLE PAGE of , <br /> L • w n ('� <br /> CHAIN OF CUSTODY PROJECT#/PROJECT NAME O.#�y <br /> CLIENT: CONTACT NAME: A N SES REQ ESTE D <br /> E=r, Tio•�� ��roc .�-.q�i..� �j <br /> ADDRESS: CITY: STATE: ZIP: 011k� TURTIM OUND!=r <br /> 1'l���s/ (�+ `l {� 0.STANDARD <br /> BILLING ADDRESS: "1; i' }! 0 RUSH <br /> J tr <br /> a4 0 <br /> PHONE#: FAX PHONE: AMPER(PRINT&SIGN NAM � I` t r �1 `DUE DATE:.— <br /> ✓ COMP. <br /> CALTEST DATE TIME CONTAINERLIENT REMARKS <br /> # SAMPLED SAMPLED MATRIX AMOUNT/TY PRE VATIVE SAMPLE IDENTIFICATION SITE CLAS# GRAB <br /> C <br /> t <br /> 4 <br /> u <br /> �c-KS C04eAr" <br /> By submittal of sarriple(s), fent,agrees to abide by the Terms and Conditions set forth on the reverse of this document. C <br /> RELIN UISHED 8 DATEIT RECEIVED BY RELIN UI HED BY DATE)TIME RECEIVED BY <br /> t <br /> $artiples:WC N�ICfjOlO ;.SAA pH? YIN <br /> TEMP: SEALED:, INTACT: <br /> MAYRIX: AQ=Aqueous Nondrinking Water,Digested Metals; <br /> ` FE=Low R.L.s, Aqueous Nondrinking Water,Digested Metals; <br /> t BD 61Q W AA._,�,__ <br /> —^�-- DW=Drinking Water; Si.=Soil,Sludge,Solid;FP=Free Product <br /> a`4 OC. AA" 7 .,�..,+�—., r � ' - CONTAINER TYPES: AL=Amber Liter;AQL=250 mL. <br /> $1L:HP PT QT VOA Amber;PT=Pint(Plastic);QT-Quart(Plastic);HG=Hall.Gallon <br /> ow, (Plastic);SJ=SoU Jar;B4=4 oz.BACT;BT=Brass Tube;VOA= <br /> t IHNOs H,SO4 NaOH 40 mL.VOA;OTC=Other Type Container <br /> CC�• . PIL•HNOg H2SO4 NaOH HCL R. PRT _MF ; <br />