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EriVIRONMENTAL CHAIN OF CUSTODY <br />QUARTERLY - p -a - - <br />Client : City of Stockton, John Frikumoto, P.E. <br />TEST <br />DESCRIPTIONS <br />- See <br />reverse <br />side <br />for <br />Cogtainer, <br />Preservative <br />and Sampling <br />information <br />Address: Public Works Department, Solid Waste Div <br />p <br />City Hatt, 425 North El Dorado Street <br />* <br />N <br />Stockton CA 95202-1997 <br />o <br />v <br />CD <br />Phone <br />Phone (209)937-8829 <br />N <br />z <br />U - <br />t - <br />Fax (209)937-8277 <br />n F-- <br />(n <br />N <br />3 11207 <br />w <br />m <br />1G <br />° _ <br />t <br />a, <br />N <br />Project Name :Austin Road Monitoring MW -2w <br />Contact person : John Fukumoto, P.E. <br />w <br />N <br />a; a r., <br />vi <br />•� <br />r -r <br />Purchase order Number: <br />CDL- <br />Cn <br />z <br />m cJ <br />= <br />z <br />QA/QC report required: Yes No <br />u <br />a) <br />w <br />w <br />0 <br />V <br />o <br />F- <br />� <br />U <br />® <br />> F-• <br />°® <br />F- <br />H� <br />.0 V <br />® <br />s�� <br />O N <br />N O <br />W <br />vi <br />s <br />mV) <br />$ <br />Vi z <br />a , a <br />=z <br />z �. <br />U <br />J <br />�) <br />¢ <br />o <br />U <br />N <br />a <br />Sampler(s): IS (d --r <br />IS. <br />•�O <br />NO <br />.O <br />N <br />Comp sampler setup Date: Time: <br />� <br />� <br />� <br />� <br />-(n <br />N <br />x <br />N= <br />Co <br />�'•O <br />® <br />z <br />N <br />_/_/_ — <br />_ <br />Rush Results due By: <br />z <br />1 <br />°-o <br />C51n <br />m <br />a <br />_/_/_ <br />c <br />_a <br />Date Received: —/_/_ <br />w o0 <br />o <br />v o <br />N <br />o <br />- W <br />d N <br />J O <br />Q •O <br />= <br />.. <br />U <br />�J <br />5 3 ®// )) <br />Lab Number:5350 �Jl <br />10 <br />N <br />100i <br />[n <br />U <br />N <br />°— <br />'t <br />' CO <br />E <br />Ln <br />4O <br />EO_ <br />9� <br />lF ^} <br />4- <br />4- <br />ate+ <br />L <br />N <br />f U <br />E <br />dl <br />1- <br />` <br />O <br />O <br />O <br />a <br />n. <br />a i+ <br />C <br />L a+ <br />U C <br />vs <br />N a+ <br />Go C <br />° <br />v <br />L a+ <br />U C <br />v <br />C <br />° <br />U <br />G! - <br />C- ° <br />Uv <br />o <br />V <br />N <br />Location/Description <br />Date Time <br />Nim <br />Sampled Sampled <br />r- <br />r <br />a <br />aw <br />w <br />a <br />o <br />e- <br />e- <br />wcSamp <br />3 <br />ti <br />1 <br />MW -2 Field Parameters <br />7/1 C/A ! <br />G <br />MW <br />1 <br />1 <br />2 <br />MW -2 Monitoring Parameters <br />re /' <br />G <br />MW <br />2 <br />1,1 <br />3 <br />MW -2 Constituents of Concern <br />', r, <br />G <br />MW <br />4 <br />MW -2 Travel Blank <br />; <br />G <br />LBW <br />1 <br />-- <br />5 <br />MW -2 Field Blank <br />, r <br />G <br />LBW <br />1 <br />Misc. Notes: <br />Relinquished By: Date: Time: <br />Relinquished By: Time: Relinquished By: Date: Time: <br />�Ia <br />Final Sample Dispostion• <br />Received by: Date: Time: <br />-- <br />R eived by: --V1DTime: a ill by. Date: Time: <br />Lab Disposal:_/_/_ Returned to Client <br />Meth. of Disposal: Date Ret. _/�/_ <br />�U 11 <br />�� �/0 ;�s //'J�' ��IlQq <br />Corporate --- <br />l ). 2f 853 &-Laboratory Office and Laboratory Fie_ Id Oitice <br />I' (lox ?i? fli3 Corporation St Brat 2500 SI �q �c�mclr Rond Vi � rl. Ca6tonu.r <br />Inti ('mina ('n 01001 n^ Inckinn. CA 9 11 I � f^0�?l i°. 1 01.-.l <br />C <br />