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CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Page of� <br /> IT CORPORATION-1326 North Market Boulevard,Sacramento,CA 95834 rr P.O.No: 163841 <br /> 91 928-3300 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 o <br /> Company: IT CORPORATION 'p <br /> Address: 1326 North Market Boulevard c <br /> Sacramento,CA 95834 <br /> Phone: (916)928-3300 c <br /> FAX: (916)928-3341 y Z <br /> Sampler's Signature: 66 <br /> z H I I IREMARKS <br /> Sample LAB Sample 4 Container.l`9Pe+ <br /> I.D. Date Time I.D. Matrix.m NP Preservations <br /> S-1 water 1 1 <br /> S-2 water 11 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X L Routine Report <br /> Signature Signature Signature Si 24 nr as hr 5 day IL Report(includes DUP,MS <br /> X standard(-10-15 wm)W days) MSD,as required,may be <br /> Printed Name Printed Nano Printed Name Printed Nam Provide VaW Preaminny Reauas charged as samples) <br /> Provide FAX preamumy Resuas III.Data Validation Report <br /> Firm Firm Firm Finn Requested Report nate: (includes All Raw Data) <br /> 1�--(MDlrV?QLWTRACE#)RWQCB <br /> Datelrime DatwTime Datefrire D ire <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Cormnents: <br /> Corrtairter 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 hahi � 819 Striker Avenue,Ste,8 500 ml LPE: 3 <br /> o....,.„,...., n.. Aco•f 4 1 t:.,.tenni• 4 <br />