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a <br />d <br />CD <br />W <br />0 <br />M M W M M M M W M M M ®®®® M r <br />CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Page _ of_ <br />Shaw Environmental, a CBI Company P.O. No: Direct Bill San Joaquin County <br />9ft IRR Prnmennde Cirele_ Suite 3211_ Snernmentn_ CA 95834 T q/,- Rr T ah. T1.1-.4sera <br />Project Name: Foothill Landfill, San Joaquin County <br />Analysis <br />Re uested <br />1st Quarter Sampling 2014 <br />Project Number. 149269 (Ground Water) <br />Report to: Sheila Richgeis, CB&I <br />t3 <br /><sheila.richgeis@CBLcom> 916-565-4327 <br />.: <br />v <br />N <br />U <br />Q <br />1) <br />5 <br />d <br />15,15 <br />Oik-0 <br />o <br />w: <br />Sampler's Signature: <br />E <br />v v; <br />-a <br />'; <br />o <br />a <br />U= <br />z <br />A <br />¢ <br />U <br />REMARKS <br />Sample 2014 LAB Sample <br />von <br />Liter LPE <br />250ml <br />500m1 <br />I lContainerTypes <br />I.D. Date Time I.D. Matrix <br />BCI <br />NP <br />NP <br />HNO3 <br />Preservations <br />_12-1A MID ZjC water <br />6 <br />3 <br />1 <br />l <br />1 <br />MW -2R tZO water <br />6 <br />3 <br />1 <br />1 <br />1 <br />MW -3 1Z4 11p1 -3 water <br />6 <br />3 <br />1 <br />1 <br />1 <br />MW -4. 01\ water <br />6 <br />3 1 <br />1 <br />1 <br />1 <br />r U 4 <br />MT T1n4E <br />MW -5 1,20 ` -5 ywater <br />6 <br />3 <br />1 <br />1 <br />1 <br />he <br />NO SS <br />LW -1 vu�7 —(o water <br />6 <br />3 <br />1 <br />1 <br />1 <br />Field Blank -7 water <br />2 <br />2 <br />$NOP <br />Tri Blank 1•'LO `� water <br />2 <br />2 <br />REQUISIIED BY <br />RECEIVED BY - <br />RELINQUISHED BY <br />RECEIVED BY <br />TURNAROUND <br />REPORT REQUIREMENTS <br />Si to re <br />Signatu <br />REQUIREMENTS <br />24 br hr day <br />X 1. Routine Report <br />H. Report (includes DUP, MS <br />i to <br />SiJpJ�gt��re� (\�j <br />iL <br />/�6: J CI L�1J , 2V ' <br />0'J4Iq 144W <br />Pri d Name <br />Pn ed <br />AAk <br />Name <br />_4s _s <br />X Stendntd(-]NIS rkinsdrys) <br />ttavide vedml Proandamy Reade <br />MSD, as required, may be <br />charged as samples) <br />Printed NamePn <br />,c�d N <br />Paul Weinhardt <br />%51 S C <br />S t cPoy <br />Firm <br />Firm <br />J� <br />Pr -id. FAx Pml m mry aema, <br />Reseed nePmt Dote. <br />III. Data Validation Report <br />(includes All Raw Data) <br />Firm <br />Firm <br />CBI <br />C <br />fLC 3 <br />DateMme 2A 1 3 <br />C (l7/ <br />Date rime <br />X RWQCB <br />(MDLs/PQLv RACE#) <br />Da[`/rime .21.1y d <br />Datelrimc �. , <br />RELINQUISHED BY <br />RF: EIVED BY <br />Special • Instructions/Comments: <br />Please report MDLs, PQLs and <br />Trace. <br />BC Labs - Tina Green <br />4100 Atlas Court <br />Sig at <br />Signature <br />o <br />NltratewN3trogeq:hsu a 48 -hr hold <br />time -,.; <br />Bakersfield, Ca 93308 <br />661-327-4911/Fx:327-1918 <br />Pn Name <br />Printed Name <br />S+�9E <br />Ship via UPS Acct 965376 <br />' Courier: Ross 661-2014171 <br />FirthPian <br />C <br />rb CL�G <br />Dat ime <br />Date/Time I - <br />t. -1A,I't t11pv <br />0 <br />0 <br />N <br />7 <br />M <br />n <br />0 <br />O <br />m <br />n <br />(D. <br />- <br />rt <br />0 <br />0 <br />A <br />O <br />Ch <br />M <br />