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CHAIN OF CUSTODY J LABORATORYANALYSIS REQUEST FORINT Page—of <br /> Shaw Environmental I r, P.O.No- Direct Bill San Joaquin Cowlty <br /> 1326 North Market Boulevar Sa CA 95834 !�D '7 C 0 Lab- <br /> Project Name:Foothill Landfill,San Joaquin County Analysis Requested <br /> Project Number: 124S911;1%--m-ehate Module)=' <br /> Report to: Sheila Richgeis <br /> Company- Shaw Environmental <br /> Address: 1326 North Market Boulevard <br /> Sacramento,CA 95834 U <br /> Dir Ph: (916)5654327 / F- • (9161 565.43 6 c � a •• N <br /> 00 <br /> Samplees Signature: ,a Z' V <br /> REMARKS <br /> ample LAB Sample Liter 125m1 50ord VOA Container Types <br /> I.D. Date Time I.D. Matrix NP NP. HNO3 HC1 i� vatioa� <br /> L-01 lal 837 water 6 1 1 . 1 3 <br /> RELII+FQUL9=BY RECENED BY �� RELIIdQQII7SHED B7[ R B TURNAROUND REPORT REQUIREMENTS <br /> REQU TS % L RoatineRepart <br /> Signature Signature Signature 2t hr �48Lc _5 day IL Report Includes DUP,MS <br /> stanaard�tatswmxmsda ) MSD,asregnired,maybe <br /> PAQNameNam® Printed Name Printed Name rm,A4avamtrm7hntattyRaaaha ciarged�as samples) <br /> "v C PmvlaaYnXr�eHminagRaaotts IIL Data Validation Repast <br /> FirmovFuns Ficin irm• RRoakdRepmtDak: ('includes All Raw Data) <br /> O % RWQCB <br /> Date rme �. .g1 Daterrme DatelTime Datell5rite <br /> (I�Ls/PQLs/TRACS#) <br /> RE WQUxzM BY RECEIVED BY S"cial Instmdions/Comments: Contai=Types Ker <br /> Cada An&iytit 40 m1 VOA: 1 <br /> Siguatare . Sig-Awe Please report MDLs,PQL-s and'Tram' 2655 Park Center Drive,Suite A 250 ml LP& 2 <br /> Nitrate-Nitrogen has a 48-hr hold time. Simi Valley,CA 93065 500 ml LP&: 3 <br /> Prated Nam Panted Name 805-526-7161/Fx 805-526-7270 1 liter HDPE: 4 <br /> Contacx:Ra=Ryaa 500 ml giaas 5 <br /> UPSAcit 9653E1 1 liter glass: 6 <br /> EDDs to<susan.wate u"@shawgrp ->. 2x6 s/s ring: 7 <br /> Datefrmre DatWrima <br /> . glass jar: 8 <br />