Laserfiche WebLink
CHAIN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM Page_of_ <br /> Shaw Environmental P.O.No: Direct Bill San Joaquin County <br /> 1326 North Market Boulevard Sacramento CA 95834 Lab: BC Labs Bakersfield <br /> Project Name: Foothill Landfill,San Joaquin County Analysis Re nested <br /> 3rd Quarter Sampling 2010 <br /> Project Number: 139867 (Lysimeters) A <br /> Report to: Sheila Richgels,Shaw Environmental 2 <br /> <sheila.richgels a shawgrp.com> 916-565-4327 b <br /> CC Report to: Jody Rhoades,Shaw Environmental aZZ <br /> 0 00 <br /> <jody.rhoades@shawgrp.com> 916-565-4362 U4. <br /> W �, <br /> O U <br /> Sampler's Signature: ; > <br /> 0 <br /> z 6 REMARKS <br /> Sample LAB Sample von L LPE 250ml 5222!CContainer T es <br /> I.D. Date Time I.D. Matrix HCl NP NP HNO3 Preservations <br /> LZ-01 water 6 3 1 1 <br /> LZ-02 water 6 3 1 1 <br /> LZ-03 water >00 <br /> 6 1 1 <br /> LZ-04 water 6 3 1 1 <br /> RELINQUISHED BY LVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X 1. Routine Report <br /> Signature Signature Signature Signature 24 hr —48 hr 5 day Il. Report(includes DUP,MS <br /> -K-Standard(-10.15 working days) MSD,as required,may be <br /> Printed Name Printed Name Printed Name Printed Name Provide verbal Preliminary Results charged as samples) <br /> Provide FAX Preliminary Results III.Data Validation Report <br /> Finn Finn Film Finn Requested Report Date: (includes All Raw Data) <br /> X RWQCB <br /> Date/Time Date/Time Date/Time Date/Time (MD Ls/P Ls/TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key: <br /> BC Labs-Tina Green 40 ml VOA: I <br /> Signature Signature Please report MDLs,PQLs and Trace. 4100 Atlas Court 250 ml LPE: 2 <br /> Nitrate-Nitrogen has a 48-hr hold time. Bakersfield,Ca 93308 500 ml LPE: 3 <br /> Printed Name Printed Name 661-327-4911/Fx:327-1918 1 liter HDPE: 4 <br /> Ship via UPS Acct 965376 500 ml glass: 5 <br /> Firm Firm Lab Courier: Ross Dickey I liter glass: 6 <br /> EDDs to<susan.waterman@shawgrp.com> 661-201-4171 2x6 s/s ring: 7 <br /> Date/Time Date/Time lassjar: 8 <br /> - . __ <br /> ..._.-....... <br />