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CHAIN OF CUSTODY /LABORATORY ANALYSIS REQUEST FORM Page_of_ <br /> IT CORPORATION- 1326 North Market Boulevard,Sacramento,CA 95834 IT P.O.No: 163841 <br /> (916)928-3300 FAX 91 928-3341 Lab: Se uoia Analytical,Sacto <br /> Project Name: Foothill Landfill,San Joaquin County Anal sis Requested <br /> Project Number: 791289 _ <br /> Project Manager: Steve Giacomini <br /> Company: IT CORPORATION <br /> Address: 1326 North Market Boulevard $ rn <br /> Sacramento CA 95834 � <br /> 00 <br /> Phone: (916)928-3300 W I„ Ito <br /> c <br /> FAX: (916)928-3341 Z <br /> Sampler's Signature: V cd <br /> REMARKS <br /> Sample LAB Sample l 4 Container Types <br /> I.D. Date Time I.D. Matrix HC1 NP Preservations <br /> MW-1 water 4 3 1 <br /> REI.1 UlSIIED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X I. Routine Report <br /> r Signature Signature 24 hr 4811r _5day I1. Report(includes DUP,MS <br /> X stsndard(-10-15 wonting days) MSD,as required,may be <br /> Pr' N d N o Printed Nama Printed None Provide Vaha1 Pre kWmy Results charged)ls samples) <br /> �t h Provide FAX Preliminary Results II1.Data V lidation Report.may- 4 F � Fern Firm Requested Report Date: (includes All Raw Data) <br /> X RWQCB <br /> Date/Tinw Datdrim Date/Time Date/Time (MD A/PQI-%q'RACEa) <br /> RELINQUISIIED BY RECEIVED BY Special Irsstnsctions/Comments: `\ Cunluinct-Types Key: <br /> ®IlF Sequoia Analytical 40 nil VOA: 1 <br /> Signature Signature Please report MDLs,PQLs and Trace. '�(�— CL 819 Striker Avenue,Ste.8 250 ml LPE: 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 I liter HDPE: 4 <br /> I inu 500 fill glans: .S <br /> Finn <br /> 1 liter gloss: 6 <br /> Dale/'I IIOd <br /> Date/7'ime 2x6 a/s riug: 7 <br /> glass jar. 8 <br />