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CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Page_of_ <br /> FMCON/OWT Inc. P.O. No: 189780 for 2002' <br /> 1326 North Market Boulevard,Sacramento,CA 95834 Lab: Sequoia Analytical,Sacto <br /> Project Name: Foothill Landfill,San Joaquin County Analysis Requested <br /> Project Number: 791289/00004000 <br /> Project Manager: Steve Giacomini o <br /> st <br /> Company: EMCON/OW'1' Inc. <br /> Address: 1326 North Market Boulevard `�° rn 00 <br /> N er <br /> Sacramento,CA 95834 0 Q <br /> Dir Ph: (916)565-4335 / X: (916)5C -4356 o W o 0 <br /> Sampler's Signature: Z O Q <br /> REMARKS <br /> Sample LAB Samplei, 1 4 1 1 1 1 1 lContainer Types <br /> I.D. Date Time I.D. MatrixHCl NP Preservations <br /> MW-1 '1YF'j water 4 3 1 Let-� <br /> MW-2 h r /� water 4 3 1 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X 1. Routine Report <br /> Sig!• it Si•nature Signature Signature 241a 48 hr 5day Il. Report(includes DUP,MS <br /> C X Standard(—l0-15worldng days) MSD,as required,may be <br /> in d N 19ritited me Printed Name Printed Name Provide verbal preliminary Results charged as samples) <br /> Provide FAX Preliminary Results II1.Data Validation Report <br /> Fin F'rni Firm Firm Requested Report Date: (includes All Raw Data) <br /> X RWQCB <br /> Datefl'inte IV—/'WT— Datefltme 10 - A <br /> - 33? Datclrime Date/rime (MDLs/PQIsfrRACEN) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Conunents: Contai ter Types hey: <br /> 1Z/ Sequoia Analytical 40 nit VOA: 1 <br /> Sigttature Signature Please report MDLs,PQLs and Trace. (/ v 819 Striker Avenue,Ste.8 250 ml LPL': 2 <br /> Nitrate-Nitrogen has a 48-hr hold time. Sacramento,Ca 95834 500 nil LPE: 3 <br /> Printed Name Printed Name 916-921-9600 1 liter HDPE: 4 <br /> Contact: Ron Chew 500 nil glass: 5 <br /> Finn Firm I liter glass: 6 <br /> 2x6 s/s ring: 7 <br /> Date/Time Datefl'inte s jai` 8 <br />