Laserfiche WebLink
0 0 0 <br />CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM page_ or_ <br />4a 3 Q k `p ('2-. P.O.# San Joaquin County P.O.021356 <br />r� w ]80 'romennde Circle. Suite 320. Sticramento. CA 95834 L.nb- RC I.nhs_ Rrnlrerslielri <br />Project Name: North County LF, San Joaquin County <br />Analysis <br />Requested <br />Ist Qtr 2013 Ground Water <br />Project Number: 139874 <br />0 <br />Report to: Sheila Richgels (916-565-4327) <br />C4 <br /><Sheiln.Rlchgels@DShawgrp.coin> <br />cc Report:.lody Rhoades (916-565-4362) <br />o �i <br /><jody.rbondes@sItawgrp.coin> <br />U <br />�; <br />Z <br />O W <br />i V) <br />b <br />N <br />7 <br />J l <br />lAhi <br />�� <br />Sampler's Signature: �lLGt,11— <br />'0 c i Cx <br />z <br />15 <br />p <br />° <br />v <br />o 5 <br />.. q . <br />V L: <br />REMARKS <br />Sample2013 LAB Sample <br />Vons 250 LPE <br />L LPE 250 1,1`13 <br />250 LPL -500 <br />LPr <br />Container Types <br />I.D. Date Time 1. D. Matrix <br />uci NP NP raaoa <br />1-1280d <br />1dNO3 <br />Preservations <br />G -I 1, ,�� <br />water <br />8 3 <br />1 1 1 <br />1 <br />1 <br />t-_ <br />G -3D 1,050 — z <br />water <br />8 3 <br />1 1 1 <br />1 <br />1 <br />G-4 - <br />water <br />water <br />8 3 <br />1 1 1 <br />1 <br />1t�e <br />G G qa`1 <br />water <br />8 3 <br />1 1 1 <br />Field Blank NIA S <br />water <br />2 2 <br />TripBlastic NJ 119 <br />water <br />2 2 <br />RELINQUISHED B1' <br />RECEIVED BY <br />RELINQUISHED 01' <br />RECEIVED BY <br />TURNAROUND <br />N <br />REQUIRENIENTS <br />24 hr _as hr dny <br />X 1. Routine Report <br />II. Report (includes DUP; MS <br />Sigi t <br />Sig/�1 re (� /f <br />Signa <br />Si Iurc <br />.re /A, <br />tt { b) 1Lt <br />/ �L~f/J j�J,C/aC <br />J i2' <br />� <br />X <br />_5 <br />S,ImdmJl-la-19 rvnrkiny dnynj <br />ProdJn Vmbnl i'rnliM,mp Ilenht <br />MSD, uc required, may be <br />charged as samples) <br />I'rhi Nnmo / j <br />Print d Name <br />Zu"'D <br />Prin I Name <br />�� <br />Printed me <br />% C! 4 <br />L (. i(�"' )i !}ljli �jj <br />. <br />D i X cy <br />y/¢ lZ% <br />P—id. rnXX NO"vi.ry R-41. <br />Rnsnn,md nnPnn M <br />III. Dain Validation Report <br />(includes All Rate Data) <br />Firm <br />Pimk� <br />Firm <br />C <br />Fir j <br />r <br />Shaw Environmental <br />C <br />X RWQCD <br />(MDLs/P IsrrRACEl1) <br />Dalenitne 1,,f fZt' <br />bnlerrimc ',23. 3 <br />Dalc(1'ime %•y3r 3 a <br />DnlerfimeZ}` <br />/ �j d <br />RELINQUISHED BY <br />RECEIVED BY <br />Special Insiruetimis/Comments: <br />Report MDLs, PQLs, and Trace. <br />Nltrnte-Nitrogen has n 48 -fir hold. <br />BC Lobs - Tino Green <br />4100 Atlas Court <br />Sigryp(�rc <br />Signature <br />Bakersfield, Ca 93308 <br />661-327-4911 / Fx: 327-1918 <br />Printed Name / <br />C�" <br />Printed Name <br />Z <br />iGtS�� j JSP ja <br />Ship via UPS Acct 965376 <br />PirntC J <br />Firm <br />�� <br />BC L1. I%$ <br />CDDs l0<9119an.i1'a(CPinmlQshnl/•grp.cnm> <br />Dalerlime 1-313 ( 3C)Dmerrh„e <br />- 130 <br />AF -L, 00. 1-a3-13 :�I`•3S K07T-- 1'23-13 --213S <br />