Laserfiche WebLink
IR <br /> ® Page—of <br /> CHAIN OF CUSTODY/LABORATY ANALYSIS REQUEST FORM <br /> Q - <br /> Shaw Environmental P.O.No: Direct Bill San Joaquin County <br /> 180 Promenade Circle Suite 320 Sacramento CA 95834 Lab: BC Labs Bakersfield <br /> Project'Natne:Foothill Landfill,San Joaquin County Analysis Re nested <br /> Resample MW-3 only. <br /> Project Number: 139867 <br /> Report to: Sheila Richgels d <br /> Company: Shaw Environmental p, d <br /> <sheila.richgels@shawgrp.com> c a <br /> Dir Ph: (916)565-4327 / FAX: (916)565-4,356 c a <br /> Sampler's Signature: �u o <br /> `D A .c <br /> C O REMARKS <br /> Sample 2011 LAB Sample4; von von Container Types <br /> I.D. Date Time I.D. Matrix ${ HCL HCL Preservations <br /> MW-3 , 4-15-1 Cf.® water 3 3 <br /> Trip Blank 4-13-11 water 2 2 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X I. Routine Report <br /> Signa Si tura Si t e netur 24 hr _48 hr _5 day II. Report(includes DUP,MS <br /> X Standard(-10-15 working days) MSD,as required,may be <br /> Pri Name Pril d Naln Pri d Nam nted me Provide Verbal Preliminary Results charged as samples) <br /> VL Q Provide FAX Preliminary Results III,Data Validation Report <br /> Firm Firm��n _ Firm� X RWQCB <br /> Finn � � Requested Report des All Raw Date) <br /> Shaw Environmental %� <br /> Date/Time j Date/Time .- Date/i'Ime 111 jgj,j ftfte-JAMDLs/P Ls/TRACE# <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key; <br /> BC Labs-Tina Green 40 ml VOA: 1 <br /> natur Signature Please report MDLs,PQLs and Trace. 4100 Atlas Court 250 ml LPE: 2 <br /> Bakersfield,Ca 93308 500 ml LPE: 3 <br /> Pted me PrintedN re 661-327-4911/Fx:327-1918 l literHDP13: 4 <br /> Mc�� Ship via UPS Acct 965376 500 ml glass: 5 <br /> Firmnn Firm (� Lab Courier: Ross Dickey 1 liter glass: 6 <br /> C� i j l2/\, EDDs to<susan.waterman@shawgrp.com> 661-201-4171 2x6 s/s ring: 7 <br /> e Datefrime %A-}3, t glassjar: 8 <br />