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LA0 r <br /> 0 <br /> L1.` A► _ SAM LE CUSTODY '56 2-34 <br /> L - • CLIENT 1 CONTACT NAME PHONE r <br /> SQ O J 7�e Uri cc+r, r <br /> Water& Hazardous Waste ADDRESS CITY STATE ZIP PROJ MGR <br /> Sampling, Analysis, & Consultation <br /> 1885 N KELLY ROAD • NAPA,CA 94558 BILLING ADDRESS Po r FAX PHONE <br /> (707) 258-4000 F.-ix (707) 226-1001 _ _l <br /> PROJECT r PROJECT NAME SAMPLER PRINT 6 S GN NAME) ANALYSES REQUESTED DUE DATE <br /> GWM <br /> la v <br /> LAS 9 COMP <br /> DATE TIME CONTAINER (Non or CALTEST <br /> SAMPLED SAMPLED MATRIX AMOUNTITYPE PRESERVATIVE SAMPLE DESCRIP ON/SITE Callestl GRAB REMARKS LAB 0 <br /> �! G <br /> 214- 1 1 1 /*4v -3 <br /> IV <br /> RELINQUISHED BY DATEITIME RECEIVED BY RELINQUISHED BY DATEf IME RECEIVED BY <br /> SHIPPING METHOD SKIPPING N RECEIVED BY DATE/TIME: CONDITION CONTAINER TYPES MATRIX <br /> AL . AMBER LITER AQ . Nondrinkrng Water <br /> J COLD YIN SEALED YIN INTACT YIN AOL . 250 m! AMBER Digested Metals <br /> z <br /> 0 AHL - 500 ml AMBER WW. Wastewalers <br /> W REMARKS Pt . Pint(Plastic) Non Digested Metals <br /> 17) HIS . Hall Gallon(Plastic) FE • Low DLS,Final Ellluent <br /> m - <br /> SJ - Sort Jar DW . Dr-' -9 Water <br /> 84 - 4 oz BACT SL . 7e/Solid <br /> Q <br /> BT o Brass Tube All <br /> ' <br /> 0 VOA. VOA I40 ml) IW - Irrki—on Water <br />