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CHAIN OF CUSTODY / LABORA Y ANALYSIS REQUEST FORM Page ' <br /> A.01 ��/. v/. _ P,O,No: Direct Bill San Joaquin County <br /> 190 Promenade Circle Suite 320 Sam-amell CA 95834 VV jx.� Lob: BC Labs,Bakersfield <br /> Project Name:Foothill Landfill,San Joaquin County . Analysis Requested <br /> lat Quatler Sampling 2012 <br /> Project Number: 139867 (Ground Water) o <br /> Repo11 to: Shelia Richgels,Show Environmental � P U <br /> <sheila.richgelat@sllawgl'p.coin> 916-565-:4327 o <br /> CC Report to: Jody Rhoades,Shaw Environmental Ij B <br /> <jody.rhoades Jshawgrp.com> 9161-5 5-4362C <br /> Sampler's Signature: x' t j G a vi 7 <br /> � o .9 0 <br /> Sample 2012 LAB SampleVOA zgo t 5oomi� REatinMARK5 <br /> Con <br /> g <br /> I.D. Date Time I.D. Matrix fflKi to HCl IVI' NP Hrr03 Prueervatinns <br /> MW-1 —Ivix 1050 water G 3 1 1 1 <br /> MW-ZR 1-12-1Z E�P1 water 6 3 1 1 1 <br /> MW-3 1-t2-t2 water 6 3 1 1 1 <br /> MW-5 water 6 3 1 I 1 <br /> flu <br /> + P SS <br /> Field Blank 1-12.12 NJ Af water 2 2 COT <br /> Trip Blank 1-12-M 14 1A water 2 2 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REWIRE MENTS X I. Roudnu Report <br /> Signaluru St taro taiu ru Si+ uru .41u ate lit s tiny II, Rupert(Includes DUP,MS <br /> X ,5lnndnrd(.lU•t5wmi;4%t4d) MSD,asruquirud,may be <br /> Printed N e P' tad Numu Pri yd Name Printed Numu Ptovid:V:tbnt Pr:ttnw,ary Ruidw charged as samples) <br /> �}bL _cr be ezo_ G'9 HCl gjgj Ptaxad:NIX Pr:tinwm),Ruldu I11.Data validation Repurt <br /> Firm Firm Finna�n Firm / Regn-d1-d R:ro,t Dms: (Includus All Raw Data) <br /> Shaw CnvirurunentalW. /J C.J_ 149 � C L/�• �j X RIVQCB <br /> Datefrime —12 1t&t':4 /,/,L, Z /Zg DaloMme / /Z•/Z / L-) Dalufrime /—/ —J 0 (MDLv/PQLvrrRACE#) <br /> RELINQUISHED BY RECEIVED BY Speeial Instructions/Cumments; <br /> BC Labs-Tina Green <br /> Signa uru Si u Pleuro report 14IDLs,PQLs and Trace. 4lDD Atir>y Court <br /> i.,u 0 ^'—' Nltnttn-Nthwgen}uts A•it3-hr hold limn. '�''� 1 6 T10 N <br /> CHK BY Bukvrv11Wd,Ca 93309 <br /> Pd.h.- Numn <br /> P <br /> 661-327-49 11/Is:327-I9 <br /> 1in> Cv� Ship via LIPS Acc96537G61w � V <br /> SUB-OUT FM' <br /> iapS / ' � <br /> EUDs to<susanavnternrnn�i�Pxhmvgt*p,com> <br /> DpataufJlimu�7.-17=I a i oo Dawfrimu Z 10 <br />