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CIA.IN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM Page_of s <br /> P.O.No: Direct Bill San Joaquin County <br /> a ® 18U Promenade Circle Suite 32U Sacramento,CA 95834 Lnb: BC Labs,Bakersfield <br /> y <br /> Project Name:Foothill Landfill,San Joaquin County <br /> Analysis Re uesled c m <br /> 1st Quarter Sampling 2013 ° <br /> ti ProjeclNumber: 139867 (Ground Water) R ,C3 5 <br /> Q <br /> z Report to: Sheila Richgels,Shaw Environmental v tq ti m <br /> x <shetla.riehgels@shnwgrp.com> 916-565-4327w °: a -- <br /> b CC Report to: Jody Rhoades,Shaw Environmental o co n H h <br /> g ° <lodyrhoades@shawgrp.com> 916-565-4362 4. d z c N <br /> o <br /> s Rolz 2! d �. <br /> Sampler's Signature: o <br /> n m " 0 vi G A <br /> a b < V L REMARKScn <br /> " �1 <br /> cSample 2013 LAB Sample von I LherLPE 2501111 500[Id Container Types <br /> ` <br /> 1.D. Date Time I.D. Mntrix 110NP NPIMG3 Prescrvntinns o <br /> toY <br /> rx& - 1 MW-2R 2.•�{ �Nl water 6 3 1 1 1 o <br /> v —2 <br /> MW-3 Z•ya3 �'L 5 water 6 3 1 1 1 101 , <br /> w <br /> w ' 3 MW_q Z-5.13 E Io, water 6 3 1 1 1 N - <br /> w � - <br /> 0e 9 .i11 M W-5 Z•'1-13 D11 water 6 3 1 t I o <br /> rn A LW-1 2!$•1?� R!'4 water 6 3 1 I t <br /> -i7 <br /> w -`•i Field Blank Z-`t't3 1-14 water 2 2 S OA H ING TIME � <br /> � C +0 N 2 O OP SS <br /> -1 Tri Blank 1-1-t3 M(i/} water 2 2 <br /> D Cl, d D MAS COT o <br /> -n o o N <br /> 9 RELINQUISHED BY RECEIVED BY RELINQUISHED BY ItECCIVED B1' TURNAROUND REPORT REQUIREMENTS <br /> REQUIRENICN'TS X 1. Routine Report <br /> W 5 Signu a Siao a ;ri.WNanl <br /> lg�ghnc Signature 24 hr -.161. _5 Joy Il. Report(includes DUP,MS <br /> vo y ��' ��t�/J. j,y;,• X Stn.dnrn(-t°-is,•r.wtog(nasal MSD,Its required,may be <br /> $" gag Print.l Nnme Priv Nam Printed Name <br /> rruvia.vr,hni rr�rminery nr,uu, charged as santptes) <br /> 1C-6-f-7 r—id.vA-X NdWinty ne�,ar. 111.Datu Validation Report <br /> Firnl rim)j� Final Finn nrmm,led nrpon Mme: (includes All Raw Data) <br /> p ° SImW);ilvlrMnmenlal 23� 1�, -7� X RWQCD <br /> Dntc/lhne Z$•t� DalcrTime / Drilerflme a,51/�j �l Daterl'im° (MDIs/PQLsfrRACG@) <br /> m RELINQUISHED BY RECEIVED It,, Special ins true tions/Cmnments: <br /> ` t C' (,, nC Labs-Tina Green <br /> g c Signa 1 c Signature Please report AIDLs,PQI,.s,[Intl Trace. \l._ OW 3q Z tD f`� 4100 Atlas,Court <br /> a Ntirnle-Nitrogen tuts it 411-hr hold time. Bakersfield,Ca 93306 <br /> Bo Printed NamePrh ted Nnnler� 661-327-4911/Fx:327-1918 <br /> o G <br /> 65 I J!5 C b Ship via UPS Aect 965376 <br /> y Final Firm Courier. Ross 661-201-4171 <br /> p- 3 . 1" lu CDD%it)<ausitn.lvalernmaQ%lllRvgrll.Call1> <br /> Dute Time - / Date-rThile � - l 13'p <br /> a. <br /> 0 <br /> -p P <br /> d <br /> rD <br /> w <br /> 0 <br /> w <br /> rn <br />