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- ® T CHAIN Oh CUSTODY <br />QUARTEREY -ems ..�. . <br />Client : City of Stockton, John Fukumoto, P.E. <br />TEST <br />DESCRIPTIONS <br />See <br />reverse'side <br />for <br />Container, <br />Preservative <br />and Sampling <br />information <br />Address: Public Works Department, Solid Waste Div`;+ <br />City Halt, 425 North El Dorado Street <br />C <br />z <br />Stockton CA 95202-1997 <br />0 <br />-> <br />1 -- <br />Phone : (209)937-8829 <br />N <br />u <br />c <br />U <br />CI. <br />Fax(209)937-8277 3-11207 <br />Cn <br />O <br />v _N <br />~ <br />o <br />N <br />Project Name : Austin Road Monitoring MW -7 <br />.n <br />m <br />>- <br />Contact person : John Fukumoto, P.E. <br />ca <br />UA <br />v <br />a; ¢ � <br />N <br />►— <br />Purchase order Number: <br />m <br />N <br />* <br />o <br />a o <br />Fes-^ <br />en a <br />m <br />� N <br />o =0-4 <br />n m <br />4A/OC report required: Yes No <br />U <br />., <br />o N <br />m <br />= z <br />J <br />c <br />o <br />In O� <br />¢z a <br />a <br />U <br />N <br />Sampler(s):_,$ , 0— <br />v' <br />s+ <br />0. <br />U <br />: O <br />nU <br />O <br />•O <br />o <br />o <br />rn <br />U <br />N <br />._I <br />'� <br />u, <br />~ <br />. <br />E <br />A <br />Comp sampler setup Date:_/_/_ Time:_ <br />c, <br />Cr <br />a� <br />_ <br />(n <br />s+- V) <br />l <br />O <br />z N <br />N <br />g <br />fn O <br />m <br />M.o <br />O c-- <br />Q <br />N <br />_ <br />Rush Results due By: <br />�, <br />o. <br />:; <br />a <br />v ^ <br />�' a <br />_/_/_ <br />c <br />z <br />z <br />.ria <br />CL <br />F --i <br />Date Received: <br />u 0 <br />0 <br />_/_/_ <br />u,°o <br />ui <br />C' <br />LnLL� <br />Ln <br />a <br />J O S <br />Cn <br />CU <br />y.0 <br />�, <br />4 <br />Lab Number: <br />0 <br />0 <br />�C'aJ+ <br />O <br />o <br />a <br />a.� <br />c <br />c <br />41 <br />U c <br />U <br />N <br />oo c <br />� <br />U c <br />I c <br />v .c <br />m <br />U c <br />Ce <br />Samp <br />Location/Description <br />Date <br />Time <br />a <br />U <br />v U <br />Q U <br />a c0 <br />_ <br />Num <br />Sampled <br />Sampled <br />�- <br />(D <br />3 <br />w <br />3 <br />,`_ <br />3 <br />V <br />1 <br />MW -7 Field Parameters <br />•7,®®/9; <br />/.Ys <br />G <br />MW <br />1 <br />1 <br />2 <br />MW -7 Monitoring Parameters <br />/ <br />G <br />MW <br />2 <br />1,1 <br />i <br />3 <br />MW -7 Constituents of Concern <br />` <br />y <br />G <br />MW <br />4 <br />MW -7 Travel Blank <br />, <br />G <br />LBW <br />1 <br />®� <br />5 <br />MW -7 Field Blank <br />G <br />LBW <br />1 <br />Misc. Notes: <br />Relinquished By: Date: Time: <br />Relinquished By: at/e:, Time: Relinquished By: Date: Time: <br />S1 /"/�� -7'y.-If' <br />� q11 z5iw 7//2/U 17,20 <br />Final Sample Dispostion: <br />Received by: Da e: Time: <br />/IL <br />_ <br />ceived by: Date: Time: eived y: D^-yatee}: Time: <br />�II <br />Lab Disposal: _/_/_ Returned to Client <br />Meth. of Disposal Date Ret. —/_/_ <br />l 1J ��' <br />rQ� 7�Z�s' // 1-o0, FTS <br />Corporate _Of[ices & Laboratory <br />I' -t) RoY 272 V)A Corporation stwol <br />/ Office and Laboratory <br />lJ 2500 Stsigc r oad l f na 1 <br />Stt 'i •I,. h i1.(A.Si'»ll <br />Field Office <br />vis iln- Califoini t <br />If 1" 1 <br />C <br />C <br />