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CHAIN OF CUSTODY / LABORATORY ANALYSIS.REQUEST FORM Page_of_ <br /> .MCON/OWT Inc. P.O.No: 211868 <br /> 1326 North Market Boulevard,Sacramento,'CA 95834 Lab: Sequoia Analytical,Sacto <br /> Project Name:Foothill Landfill,San Joaquin County Analysis Re nested <br /> Project Number: 791289/00003000 <br /> b <br /> Project Manager: Steve Giacomini H a <br /> Company: EMCON/OWT Inc. o <br /> Address: 1326 North Market Boulevard 00 <br /> Sacramento,CA 958A �j <br /> Dir Ph: (916)565-4335 / F (916)56,5-4356, 4. W o o v <br /> ar <br /> Sampler's Signature: vi z <br /> z > REMARKS <br /> Sample LAB Sample 1 4 3 Container Types <br /> I.D. Date Time I.D. Matrix HCl NP HNO3 Preservations <br /> MW-1 -t5 water 5 3 1 1 <br /> MW-2R _13 t7Z3 water 5 3 1 1 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X L Routine Report <br /> Si Signature Signature Signature 24 hr 48 hr 5 day H. Report(includes DUP,MS <br /> X standard(-10-i5 working days) MSD,as required,may be <br /> Pr"Name Primed ame U Printed Name Printed Name Provide verbal Preliminary Results charged as samples) <br /> -rA vn ^ Provide FAX Preliminary Results III.Data Validation Report <br /> Firm Firm Requested Report Date: (includes All Raw Data) <br /> Firm nn rm s n X RWQCB <br /> Date/Time 18-15-pa DateHimeRJ1&61 tL4 1I Dawrime Date/Time (MDLs/PQLs✓TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key: <br /> Sequoia Analytical 40 ml VOA: 1 <br /> Signature Signature Please report MDLs,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 Namc 916-921-9600 1 liter IIDPE: 4 <br /> Contact: Ron Chow 500 mlglass: 5 <br /> Firm Firm 1 liter glass: 6 <br /> 2x6 s/s ring: 7 <br /> Date/rime Date/Time glass jar: 8 <br />