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CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Poge_ofV w <br />P.O. No: Direct Bill Son Joaquin County a <br />�atICY) \ACA l i.ah, BC Labs. Bakersfield Q <br />�( 1SD i'romenaae Circle aurae aLu, <br />Project Name: Foothill Landfill, San Joaquin County <br />Analysis Re uested <br />1st Quarter Sampling 2013 <br />0 <br />Project Number. 139867 (Lenchate) <br />Report to: Sheila Richgeis, Show Environmental <br /><slieiln.richgels@sliuwgrp.coni> 916-565-4327 <br />CC Report to: Jody Rhoades, Shaw Environmental <br /><jody.rhoades@shmvgrp.com> 916-565-4362 <br />/, <br />Sampler's Signature:74J (� Ja <br />o <br />v <br />oo d <br />°o cora c w m <br />b z b <br />o � z o <br />ci C <br />" ' o WO <br />REMARKS <br />Sample 2013 LAB Sample <br />LD. Date Time I.D. Matrix <br />I, t.re 250114 500nd VOA <br />C011111 [ter Types <br />hrr Nr IIN03 NO Preslrvllion5 <br />L -OI 2-103 '5 water <br />6 I 1 1 3 <br />CHK EY DIST-Plau <br />1 1014 <br />l <br />- <br />r -r+6 <br />IIELINQUISIIED DY <br />RECEIVED By <br />RELINQUISHED 1IV RECEIVED BY <br />Signa to Signa r• <br />�yyj <br />Prim Name Prinlcd Nati1C <br />s`.i..� a V Q /�-rt1 <br />Firm //� r ���J,,� Firm //�� // nn )� <br />�`'' C--/ /TfJ <br />TURNAROUND <br />REQUIRGQIENTS <br />24hr _481" _5doy <br />X sie�d,ra 1-11-ts „orkils d,y,t <br />rr-id, v„ h l rrcaminnry li„1a, <br />ltvVW, nns rrrnmt,�n• n�1,n, <br />ilq�.ud n,i�o1 N e: <br />REPORT REQUIREMENTS <br />X I. Routine Report <br />11. Report (includes DUP, N45 <br />MSD, as required, may be <br />charged as snmpics) <br />M. Data Validation Rcpon <br />(includes All flit\v DUIU) <br />X R\VQCD <br />Si fruSi <br />uCtra <br />C�� <br />1'n d Nmne <br />, 114 ). . _� n <br />1NEe� <br />Prh d Nnm <br />C . f <br />Firm <br />Picot �� <br />Show Enviromucraid <br />DntclTime Z J' <br />RELINQUISHED DY <br />Da(c1Tboa ;)-r •/ 3 <br />RECEIVED BY <br />Trr /J <br />Di icrrinte /D <br />Special Instrucliens/Comments: <br />OC Lobs - Tina Green <br />(MDL/PQLs/TRACG) <br />Container nil l <br />40 ml VOA: <br />I <br />Plense report IDLs, PQLs and Trace. <br />Nitrate -Nitrogen has a 48-125• hold time. <br />, <br />L,t Oo D �� � ClJOSt,o <br />EDDs in <susan.oatcnnnn n shmvgrp,c6m> <br />4100 Atlas Court <br />BukersFeld, Cn 93308 <br />66)-327-4911 / Fs: 327-1918 <br />Ship via UPS Acc1965376 <br />Courier:' Ross 661-201-4171 <br />250 ml L['E: <br />500 nil LPE: <br />1 liter HDPE: <br />500 nil glass: <br />l liter glass: <br />2N6 s/9 ring: <br />gla s jar: <br />2 <br />3 <br />4 <br />5 <br />G <br />7 <br />8 <br />Signs r e <br />n C <br />Signator <br />Printed Namc <br />2 �,,9 �} <br />V <br />Printed Nate <br />t r ��b� <br />= <br />Pion <br />ac.I�' <br />Firm <br />-aci,••�. <br />Daterrinte A-,5-/ • I7 <br />IJnicfl'inte 9. •( /fS}. O <br />j --L-- �a X-5-13 a !30 <br />M <br />