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r <br /> A _ SAAE CUSTODY "u ` � � 14v y <br /> `r L — CLIENT _ CONTACT NAME PHONE# <br /> Water & Hazardous Waste ADDRESS G 5 CITY STATE ZIP PROD MGA <br /> Sampling Analysis, & Consultation <br /> 1885 N KELLY ROAD • NAPA,CA 94558 BILLING ADDRESS PO # FAX PHONE <br /> (707) 258-4000 • Fax (707) 226-1001 <br /> PROJECT# PROJECT NAME SAMPLER(PRINT&SIGN NAME) ANALYSES REQUESTED DUE DATE <br /> I/17 <br /> 1. <br /> LAB# <br /> DATE TIME CONTAINER (Non <br /> GREYEST <br /> RA' <br /> SAMPLED SAMPLED MATRIX AMOUNT)TYPE PRESERVATIVE SAMPLE DESCRIPTION/SITE Callest GRAB REMARKS LAB# <br /> RELINQUISHED iBY DATE IME RECEIVED BY RELINQUISHED BY DATE'TIME RECEIVED BY <br /> SHIPPING METHOD SHIPPING# RECEIVED BY DATE/TIME CONDITION CONTAINER TYPES MATRIX <br /> AL = AMBER LITER AQ = Nondrinking Water <br /> Z COLD(Y! SEALED(1/N INTA �N AOL= 250 ml AMBER Digested Metals <br /> 0AHL r ► AHI. = 500 ml AMBER WW w Wastewaters <br /> 112) REMARKS �GI&AI Pt = Pmt(Plastic) Non Digested Metals <br /> 0 <br /> HG = Hall Gallon(Plastic) FE = Low DLS Final Effluent <br /> m SJ = Soil Jar DW = Drinking Water <br /> 84 = 4 oz BACT SL = Sad/Sludge/Solid <br /> ¢ r BT = Brass Tube AR = Air <br /> w -- — — <br /> VOA= VOA(40 ml} tW = Irw later <br /> OTC = Other Type Container N[ sd Metals <br />