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CAIN OF CUSTODY RECOR01 <br /> 3AMPLERS:(signature ` QIIr;,rl ��/ _� force. <br /> SHIPPING INFORMATION <br /> b <br /> Phone: <br /> SHIPTO: Shipper ^ y <br /> c i1 /4.ti41 Address �rif �C 7r'i"nc <br /> QV-o Date Shipped <br /> Shipment Service <br /> Airbiil No. <br /> ATTENTION: !:p.v 3 Cooler No. <br /> Phone No. <br /> Relinquished by:,(signaturoj ;% Received by: (signature)J Date/Time <br /> ILL <br /> Relinquished by: (signature) Rereived by: !signature) Date/Time <br /> Relinquished by: (signature) Received by: (Signature) Date/Time <br /> Rellii�quished byesignature) 7e—,velo, laboratory by':(Signarure) Date/Time <br /> ' Analysis laboratory should cormplete, "sample conditionupon receipt", section below, sign and return top copy to <br /> 1 <br /> J. H. KLEINFELDER 8 ASSOCIATES, 0-1c- <br /> ...Olympic-Blvd.-,--Su <br /> 94596 <br /> Sample Site Date Analysis Sample Condition <br /> Number Identification Sampled Requested Upon Receipt <br /> 'w�f�NriUi"1 -3 <br /> `�"nib+wlt�Yl tC <br /> T•:�A! r!'ICNP' <br /> AiSep <br /> !v 07- A ( / 0/ r%/ /�l <br /> LAB INSTRUCTIONS: Laboratory reports should reference and be billed by site ID# and contain the following: <br /> (1) summary of analytical methodology and QA work (blanks, spikes, duplicates) <br /> (2) dates for (a) sampling, (b) lab receipt, (c) extraction, (d) injection/analysis <br /> (3) detectionlimits for all constituents analyzed for and reporting of all constituents detected which were not <br /> specifically designated <br /> (4) <br /> (5) <br /> PIfFSP SPNP� QPSu ��S 0 �i �l. lC. sac lc) (rJ� , fF, 4?{,,•, !lv�:� /'.v� i� l d <br />