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CHAIN OF CUSTODY/LABORAMRY ANALYSIS REQUEST FORM Page � <br /> P.O.No: Direct Bill San Joaquin County <br /> Shaw® ' 180 Promenade Circle Suite 320 Sacramento CA 95834 Lab: . BC Labs,Bakersfield <br /> Project Name: F'dothili Landilli,Snu Joaquin County Anal sis Re vested <br /> 1st Quarter Sampling 201.2 <br /> Project Number: 139867(Leaclinte) o <br /> Report to: Sheila Richgels,Shaw Environmental <br /> <sheila.rlchgels@shawgrp.com> 916-565-4327 'S b <br /> CC Report to: Jody Rhoades,Shaw Environmentai o <br /> <jody.rhoades@shawgrp.com> 916-565-4362 U <br /> c <br /> 4-1 <br /> o ti o 00 :a <br /> Sampler's Signature: <br /> PwN Q 0 <br /> o �- <br /> yv o REMARKS <br /> Sample 2012 LAB Sample L LPL 250m1 5001111VOA Container Types <br /> I.D. Date Time 1.D. MatrixNP NP HNO3 HCl Preservations <br /> L-01 water :6`. 1 1 1 3 <br /> CHK BY DISTRI TION <br /> SUB-OUT 0 <br /> r—r= 10411 TIME <br /> RAS <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREbIENTS <br /> REQUIREMENTS X 1. Routine Report <br /> Sig fur Sign (� Si nu ire Si alure 2a hr 4B hr �5 day 11. Report(includes OUP,MS <br /> j�l-rr Q 6�{ ,�° u. SL ,rri`✓ X Standard(-10.15 workingdays) MSO,as required,may be <br /> Pdiii):d Nnnif� - l Prfn Name Pri d Name Printed nme Provide Verbal Preliminary Results charged as samples) <br /> Ut- Wtln * r � tis ��� L (� Ky 6 0 JJ ProvidaF&xPreliminary Results i1L Data Validation Report <br /> Firm FirmFirs Firm Requested Report Dare: (includes All Row Data) <br /> show Crivirnmcn(oi . Bc 6 13 C `./4-�'S X RWQC13 <br /> Dolefrime I-11-IL l Daterrimc • 'L ) Dntc/limc/�( ,� Datc/Timc -11-t1 16-50 (MDLs/PQLs/TRACEII) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key; <br /> 13C Labs-Tina Orcen 40 ml VOA: I <br /> sign lure re Plensc report 4-IDLs,PQLs and Truce. 4100 Atlas Court 250 ml LPE: 2 <br /> Tat-IA - 1 nTatuNitrate-Nitrogen fins n 48-hr hold time. Bakcrsticld,Co 93308 500 ml LPL': 3 <br /> t 'rintedN c fated tc 661-327-4911/Fx:327-1918 1literHDPE: 4 <br /> p Ship vin UPS Acct 965376 500 nil glass: 5 <br /> Firmq Firm /I p 1 liter glass; 6 <br /> /jc �/t -5 2 !-. EDDs to 4susna.wnternlnn@shnwgrp.com> 2x6 s/s ring: 7 <br /> Date rime I'-11-t2, / n Dni a .L• glass lar: 8 <br /> ai 3b <br /> -------------- <br />