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11 <br /> n <br /> s° CHAIN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM[ Page , of w <br /> 2.,—CO iJjC � P.O.No: Direct Bill San Joaquin County c <br /> a ®' 180 Promenade Circle Suite 320Sacramento CA 95834 Lab: BC Labs,Bakersfield n j <br /> Project Name:Foothill Landfill,San Joaquin County Analysis Re uested (a <, <br /> 1st Quarter Sampling 2012 On 3 <br /> a" <br /> Project Number: :139867(Leachate) o ,< N <br /> Report to: Shella Rieltgels,Shaw Environmental 0 n A av <br /> o <sheila.rlchgels®shawgrp.com> 916-565-4327 d o. m <br /> o a CC Report to: Jody Rhoades,Shaw Environmental c Oct a n H. <br /> o p] 0 ro <br /> C) <br /> <jody.rhondes a shawgrp.com> 916-565-4362 w p�p p_ <br /> N <br /> Sampler's Signature: A 1 p z c z a U 0 C�i1 <br /> n QAJt C� m oB U n o <br /> b U 2 > w REMARKS rD. � <br /> t° <br /> sample 2012 LAB Sample LLPE Min! 50011ti von Container Types ` <br /> w _ I.D. Date Time I.D. Matrix NP NP HNO3 ]tc3 Preservations <br /> L-01 1-11-32. ,SO "� water 6, 1 1 1 3 � A • <br /> o <br /> D <br /> ca 0 C K BY DISTRI TION <br /> C) <br /> s <br /> SUB-OUT M <br /> ro <br /> N � m <br /> ,f <br /> rho A 0 <br /> eeTtd <br /> XE <br /> c 6' RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREY[ENTS <br /> o REQUIREMENTS X 1. Routine Report <br /> G <br /> a Sag Al-u-r� Sigtiat !1 Signu rre 51 paturc 34 hr _aete _sdry fl. Report(includes DUP,MS <br /> CA S ay tX GV' La{�,!e' J1Lr c C / X Siondonl(-ta•IS working doyr) MSD,as required,may he <br /> y <br /> Pr;d d Namf Print Nnma Pri d Name Printed ame Provide vrr�i rrma m¢y ansdts charged as smnples) <br /> ° 17L Wk-1M�s¢�Or P-SS (, K`/ C6l4tw�deFa�rrraminarya�aous Ill.Data Validation Report <br /> ao� <br /> Firm firms rirm Firmr� Regnenrd ngou Dine (includes All Raw Duta) <br /> 2 Shaw Environmental . /JCf�f L5 /J C ✓!J'{-b.S X RWQCB <br /> 5 m Datelrime I-11-IL l DoiriTime , • Z'L! Datell•ime/, -M— Dalelrime/-!!-/z / (MI) fP LsfrRACEN) <br /> aRELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key: <br /> 08C S BC Lobs-Tina Green 40 nil VOA: 1 <br /> 51g�t lure nnturc Please report AIDLs,PQLs and Trace. 4100 Atlas Court 250 ml LPE: 2 <br /> 3 ! arm - Nitrile-Nitrogen has a 48-hr hold(line. Balrcrsfield,Ca 93308 500 ml LPG: 3 <br /> a rinted Nfige Pflnted Wic 661-32749111 Fx:327-1918 1 liter HDPE: 4- <br /> o p C-40 Ship via UPS Acct 965376 500 nil gloss: 5 <br /> Firm rine ( n � Ilitergiuss: 6 <br /> i �j C G/� S C�-r EDDs to<susan,wntcrmnnCsltnwgrp.cnm> 2x6 s/s ring: 7 <br /> Daterrime /'/(- o /T <br /> Z. / Dot ' a.• glass-lar: 8 <br /> -O t' <br /> N <br /> m <br /> a) <br /> W <br /> O <br /> V <br />