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CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Page —of _ <br />P.O.# San Joaquin County P.O.#21356 <br />A !":« tQ 1I 'A7n CA ocA'Aa Lab: BC Labs. Bakersfield <br />Project Name: North County LF, San Joaquin County <br />Analysis Requested <br />2013 Annual Surface Water Parameters <br />Project Number: 139874 <br />0 <br />Report to: Sheila Richgels (916-565-4327) <br /><Shel1a.R1chgels@Shawgrp.corn> <br />x <br />cc Report: Jody Rhoades (916-565-4362) <br />N <br />o <br />b <br /><jody.rhoades@shawgrp.com> <br />U a o d <br />Z <br />o to o <br />v <br />Sampler's Signature: <br />O° <br />o <br />O <br />CT <br />I I IREMARKS <br />U <br />Sample <br />2013 <br />LAB <br />Sample <br />VOAs S L <br />2 <br />250 LPE 500 LPE <br />Container Types <br />I.D. <br />Date <br />Time <br />I.D. <br />Matrix <br />1101 <br />HNO3 <br />142504 HNO3 <br />Preservations <br />S-1 <br />r <br />8 1 <br />1 <br />1 1 <br />S-2 <br />ter <br />8 1 1 <br />1 <br />1 1 <br />el <br />YM <br />RELINQUISHED BY <br />RECEIVED BY <br />RELINQUISHED BY <br />RECEIVED BY <br />TURNAROUND <br />REPORT REQUIREMENTS <br />REQUIREMENTS <br />24 hr 48 hr _5 day <br />X 1. Routine Report <br />11. Report (includes DUP, MS <br />Signature <br />Signature <br />Signature <br />Signature <br />X Standard (-10-15 working days) <br />Provide Verbal Preliminary Results <br />MSD, as required, maybe <br />charged as samples) <br />Printed Name <br />Printed Name <br />Printed Name <br />Printed Name <br />- <br />Provide FAX Preliminary Results <br />Requested Report Date: <br />III. Data Validation Report <br />(includes All Raw Data) <br />Finn <br />Firm <br />Firm <br />Firm <br />Shaw Environmental <br />X . RWQCB <br />MDLs/P Ls/TRACE{t <br />Date/Time <br />Date/Tinte <br />Date/Time <br />Date/Time <br />RELINQUISHED BY <br />RECEIVED BY <br />Special Instructions/Comments: <br />Report HDLs, PQLs, and Trace. " BC Labs - Tina Green <br />Nitrate -Nitrogen has a 48 -hr hold. 4100 Atlas Court <br />Signature <br />Signature <br />Bakersfield, Ca 93308 <br />661-327-4911 / Fx: 327-1918 <br />Printed Name <br />Printed Name <br />Ship via UPS Acct 965376 <br />Courier: Ross 661-201-4171 <br />Firm <br />Firm <br />EDDs to <susan.waterman@shawgrp.com> <br />Date/Time <br />Date/Time <br />