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J � J <br /> SAMPLE CUSTODY '�B# 505S Lj+� <br /> 'c • ' • • CLIENT CONTACT NAME PHONE# <br /> d Water&Hazardous Waste ADDRESS CITY STATE ZIP PROJ MGR <br /> Sampling, Analysis, &Consultation <br /> 1885 N KELLY ROAD • NAPA,CA 94558 BILLING ADDRESS P 0 # FAX PHONE <br /> {707} 258-4000 4P Fax{707} 226-1001 R•-V aoe72. <br /> PROJECT# PROJECT NAME SAMPLER(PRINT&SIGN NAME) ANALYSES R E Q U E 5 T E D QUE QATE <br /> t <br /> LAB# <br /> DATE TIME CONTAINER (Non or CALTEST <br /> TL SAMPLED SAMPLED MATRIX AMOUNTlTYPE PRESERVATIVE SAMPLE DESCHIPTIONISITE Caltestl GRAB REMARKS LAB# <br /> J� <br /> rr <br /> 19n A& NA/A O A/-/ x <br /> T _ <br /> J� <br /> " r <br /> 6 <br /> RELINQUISHED Y DATE IME RECEIVED BY RELINQUISHED BY DATEMME RECEIVED BY <br /> 7 <br /> 4 <br /> SHIPPING METHOD SHIPPING# RECEIVED BY DATPiIME CONDIT N CONTAINER TYPES MATRIX <br /> GOLD ! SEALED IN INTA AL 4 AMBER LITER AO - Nondnnking Water <br /> y+` = AOL- 250 ml AMBER Digested Metals <br /> p �G # AHL - 500 m! AMBER WW m Wastewaters <br /> w REMARKS 07, r +'• (�+ • Ad Pt - Pint(Plastic) Non Digested Metals <br /> JA HG . Half Gallon(Plastic) FE - Low DLS Final Effluent <br /> am Ex 169MAN SJ . Sod Jar DW - Drinking Water <br /> 'tkceivcd a c. ----� ,'JG .4 84 . 4 o BACT SL - Soil/Sludge/solid <br /> 1c BT - Brass Tube AR - Air <br /> 1 , VOA. VOA(40 ml) IW �abon Water <br /> LL <br /> OTC. Other Type Container Digested Metals <br />