Laserfiche WebLink
CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Page J of <br /> JN/OWT Inc. P.O.No: 189780 for 2002' <br /> .6 North Market Boulevard Sacramento CA 95834 Lab: Sequoia Anal 'cal,Sacto <br /> .1roject Name:Foothill Landfill,San Joaquin County Anal sis R nested <br /> Project Number: 791289/00004000 <br /> . � b <br /> Project Manager:.Steve Giacomini <br /> Company: EMCON/OWT Inc. <br /> Address: 1326 North Market Boulevard Cq I <br /> Sacramento,CA 95834 00 <br /> U-< ,b <br /> dGo <br /> Dir Ph: (916)565-4335 / FAX: 916)565-435 o W o <br /> z <br /> Sampler's Signature: <br /> REMARKS <br /> Sample LAB Sample 1 4 Container Types <br /> LD, Date Time I.D. Matrix HCI I NP Preservations <br /> MW-3 (0-IS' 1006 water 4 3 1 <br /> Field Blank N water 2 2 <br /> Trip Blank 40, N)A water 2 2 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X l Routine Report <br /> Si Si o Signature Signature 24hr 48hr 5 day H. Report(includes DUP,MS <br /> X 8wWard(-10.15.,W.g day.) MSD,as required,may he <br /> amo Name � ®® Prided Name Printed Name Provide Vefl d Prdin i utt.Re. charged as samples) <br /> (r 1V& Q 1 r t n t 9• I t f r Provide PARPrelimi WR=tts HL Data Validation Report <br /> FimV FirmS� U$t Firm Firm Requested Report Date: (includes All Raw Data) <br /> X RWQCB <br /> Date/Time & eOZ Date/Timo (Q •L (:(S Date/time Date/Time (MDLs/PQI,&1TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instmetions/Comments: Container Types Key- <br /> Sequoia Analytical 40 ml VOA i <br /> Signature Signature Please report MDLe,PQLs and Trace. 819 Striker Avenue,Ste.8 250 ml LPE: 2 <br /> Nitrate-Nitrogen has a 48-hr hold time. Sacramento,Ca 95834 500 ml LPE: 3 <br /> Printed Name Printed Name 916-921-9600 1 liter HDPE: 4 <br /> Contact: Ron Chew 500 ml glass: 5 <br /> Firm Firm - _ ' ` �`_' ::- 1 liter glass: 6 <br /> A^`'' <br /> i~ 2x6 s/s ring. 7 <br /> Date/Time Date/Time glasajar. 8 <br />