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CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Page_of_ <br /> EMCON/OWT Inc. P.O.No: <br /> 1326 North Market Boulevard Sacramento,CA 95834 Lab: Sequoia Analytical <br /> Project Name:Foothill Landfill,San Joaquin County Analysis R u <br /> First Storm Event 2002-2003 .y <br /> Project Number: 791289 rn <br /> Project Manager: Steve Giacomini <br /> c' <br /> Company: EMCON/IT Inc. 0 <br /> Address: 1326 North Market Boulevard 0 <br /> Sacramento,CA 95834 o U w <br /> Phone: (916)565-4335 / FAX: (916)565-4356 6 <br /> Sampler's Signature: ` ----- z F- REMARKS <br /> Sample LAB Sample4 Container Types <br /> I.D. Date Time I.D. Matrix NP JPreservatiom <br /> S-1 /2 az-0 1 ti�-5' water 1 1 Mill 15 r) <br /> S-2 '7-cam water 1 1 <br /> RELINQUISHED BY R EIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X L Routine Report <br /> Si tura Ekw'E& <br /> Signature Signature 24 br 4ghr 5 day IL Report(includes DUP,MS <br /> X standard(—leu working days) MSD,as required,may be <br /> Printed Name Name Printed Name Printed Name Provide Verbal Pretiminery Results charged as samples) <br /> 9AProvide FAX Preliminary Results III.Data Validation Report <br /> Firm I 4 Firm Firm Requested Report Date: (includes All Raw Data) <br /> 12-17-et- O`i`l�Ca '- (, a.--- X RWQCB <br /> DaWrirne Date/Time Date/Time Date/Time (MDLs/PQLs/TRA.CE#>) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: L Container Types Key: <br /> a Sequoia Analytical 40 ml VOA: 1 <br /> Signature Signature Please report MDLs,PQLs and Trace. 819 Striker Avenue,Ste.8 250 ml LYE: 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 I liter HDPE: 4 <br /> Contact: Ron Chew 500 ml glass: 5 <br /> Firm Firm l liter glass: 6 <br /> 2x6 s/s ring: 7 <br /> Date/Time Date/Time glass jar: 8 <br />