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JW aft IM No JIM <br />Page 1 of 1 <br />Chain of Custody Record <br />Special Instructions <br />40 <br />COC Number APPL-0168 <br />ATTN: <br />Relinquished by Z " <br />Airbill No. <br />Sample Custody <br />Report Copy to <br />Received by 1[ 67 /6Z <br />-G— <br />Lab Name APPL <br />and <br />Project Name Forward LF GTF <br />Project Number 353024.01.01.01 <br />Lab Phone (559) 275-2175 <br />Friday, October 19, 2007 <br />(530) 229-3428 <br />Project Location Manteca, CA <br />Project Manager John Burke <br />Turnaround Time 21 <br />days <br />C2iMH1LL <br />Task Order <br />Sample Manager Chris Goodrich <br />QC Level 2 <br />Lab 1 # FAP—PL Lab <br />2 # <br />Project Forward Landfill GTF-Annual2 <br />(530) 788-0895 <br />For Lab Use <br />Sample Date/Time <br />Field ID Type Matrix # Containers Analysis Requested <br />Field Filtered Remarks <br />Labl Lab 2 <br />02 -Nov -07 <br />GWTF-EFL 1107 N GROUNDWATE <br />R <br />I <br />SW6010B <br />❑ ICAP 14 DISSOLVED METALS, must be <br />filtered and acidified by APPL <br />3 <br />SW8260B <br />❑ VOAs (Use Table Vanalyte list in <br />Purchase Order 919914. Do not analyze <br />for Ethanol, Tertiary Butyl Alcohol, or <br />Hexachloroethane). Rinse instrument <br />prior to analysis. <br />Total Containers 4 <br />02 -Nov -07 <br />GWTF-INF_1107 N GROUNDWATE <br />R <br />3 <br />SW8260B <br />❑ VOAs (Use Table V analyte list in <br />Purchase Order 919914. Do not analyze <br />for Ethanol, Tertiary Butyl Alcohol, or <br />Hexachloroethane). Rinse instrument <br />prior to analysis. <br />Total Containers 3 <br />02 -Nov -07 <br />TB -517 TB WATER <br />I <br />SW8260B <br />❑ VOAs (Use Table V analyte list in <br />Purchase Order 919914. Do not analyze <br />for Ethanol, Tertiary Butyl Alcohol, or <br />Hexachloroethane). Rinse instrument <br />prior to analysis. <br />Total Containers 1 <br />Signatures Date/Time <br />Shipping Details <br />Special Instructions <br />Sampled by a ` /%2-"� OZ•S-3 <br />Method of Shipment FED EX <br />ATTN: <br />Relinquished by Z " <br />Airbill No. <br />Sample Custody <br />Report Copy to <br />Received by 1[ 67 /6Z <br />-G— <br />Lab Name APPL <br />and <br />John Burke/RDD <br />Relinquished by <br />Lab Phone (559) 275-2175 <br />Leonard Fong <br />(530) 229-3428 <br />Received by <br />