Laserfiche WebLink
M M ® M M M M M = M M M M M ® M M M <br /> CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Page_of_ <br /> EMCON/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: 791289/00002000 _ <br /> Project Manager: Steve Giacomini T' <br /> Company: EMCON/OWT Inc. <br /> Address: 1326 North Market Boulevard 00 <br /> Sacramento,CA 95834 0 <br /> U ani <br /> Dir Ph: (916)5654335 / FAX: (916)5654356 0 00 <br /> 66 <br /> Sampler's Signature: b w <br /> REMARKS <br /> Sample LAB Sample 4 Container Types <br /> I.D. Date Time I.D. Matrix NP Preservations <br /> S-1 water 1 1 <br /> S-2 water 1 <br /> RELINQUISHED BY RECEIVED BYRELINQUISHED BY RECEIVED BY TU AROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X I. Routine Report <br /> Signature Signature Signature Signature 24 l 48 l 5 day II. Report(includes DUP,MS <br /> X Standard(-10-15 worldng days) MSD,as required,may be <br /> Printed Name Printed Name Printed Name Printed Name Provide Verbal Preliminary Results charged as samples) <br /> F Provide FAX Preliminary Results III.Data Validation Report <br /> inn Firm Finn Firm Requested Report Date: (includes All Raw Data) <br /> X RWQCB <br /> Date/Time Date/Time Date/Time DateJTime (MDLs/PQLs/TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key: <br /> 40 ml VOA: 1 <br /> Signature Signature Please report MDLs,PQIA and Trace. Sequoia Analytical 250 ml LPE: 2 <br /> Nitrate-Nitrogen has a 48-hr hold time. 819 Striker Avenue,Ste.8 500 ml LPE: 3 <br /> Printed Name Printed Name Sacramento,Ca 95834 1 liter HDPE: 4 <br /> Finn916-921-9600 500 ml glass: 5 <br /> Fum Contact: Ron Chew 1 liter glass: 6 <br /> Date/Time Date/Time 2x6 s/s ring: 7 <br /> glass jar: 8 <br />