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CHAIN OF CUSTODY / LABORATORY ANALYSIS REQUEST FORM Page —ot_ <br />n P.O. Direct bill to San Joaquin County <br />Ot >tl.r+®rsar® ._ r neaie -,1- 2 !2." (3 / ;7- .i "S i.nh• Fir l.nhc. Rnlrersricid <br />%wpm ■"WN Ja4 1 1 V1/1-1- <br />Project Name: Corral Hollow LF, San Joaquin County <br />- <br />Anal <br />sis <br />Requested <br />1st Qtr 2012 Ground Water <br />ProjectNumber: 139881 <br />Report to: Sheila Rlchgels, Shaw Environmental <br />6 <br />b <br />(;t-i4C <br />Y <br /><sheila.richgels@sltnwgrp.com> 916-565-4327 <br />ob <br />, <br />4U OUT <br />CC Report to: Jody Rhoades, Shaw Environmental <br />o <br />c <br />a/ <br /><jody.rboades@showgrp.com> 916-5 -43G2 <br />0 <br />� 0 <br />rn <br />Z <br />�10 <br />b <br />Sampler's Signature: <br />Q <br />U <br />w <br />v <br />REMARKS <br />Sample <br />2012 <br />LAB Sample <br />3 <i <br />LLPa <br />250ml <br />VOAa <br />5001n1 <br />lConlainarTypos <br />I.D. <br />Date <br />Time 1.D. Matrix <br />>: >^<: <br />NP <br />NP <br />FIC) <br />HNO3 <br />Prescrvulions <br />MW -4 <br />1•ZS-17- <br />I)II water <br />6 <br />1 <br />1 <br />3 <br />1 <br />MW -5 <br />I DI1 water <br />6 <br />1 <br />1 <br />3 <br />1 <br />SB -1 <br />03b — water <br />6 <br />1 <br />1 <br />3 <br />1 <br />MW -6 <br />C1 3, water <br />6 <br />1 <br />1 <br />3 <br />1 <br />MW -7 <br />I�b water <br />6 <br />1 <br />1 <br />3 <br />1 <br />N T ME <br />MW -8 <br />Bat° ` U% water <br />6 <br />1 <br />1 <br />3 <br />1 <br />Cr+e NO2 Oa O SS <br />Field Blank <br />fa �rT water <br />2 <br />2 <br />Cl Op BA COT <br />Trip Blank <br />fNji9 <br />water <br />2 <br />2 <br />RELINQUISHEDBY <br />RECEIVED BY <br />RELINQUISHED BY RLt'CEWED BY TURNAROUND REPORT REQUIREMENTS <br />REQUIREII?IETVTS X 1. Routine Report <br />Sig ure Signature 24 hr -4s hr -5 day 11, Report (includes DUP, MS <br />Signal r <br />Sig u a <br />L 4e -r_ X standard (-10.15 warklns days) MSD, us required, may be <br />r{ d No Printed Na aProvide verbal Prellobary Results charged as sumpias) <br />i into Nam <br />Az1QA <br />17 <br />Provide. PAX Pranminnry 11mults III. Data Validation Report <br />Firm Firm --, '! Requested Repan Data; (includes All Row Data) <br />X RWQCB <br />Firm <br />Shaw Environmental <br />e 1 <br />Daterrime / Dalcrrimc /- - a / p (MDCx/PQLsrfRACEI/ <br />Dalcrrima lt- v <br />DaterTtnte <br />RELINQUISHED BY <br />RECEIVED BY <br />Special Instruetlons/Comments; Container Types Kay: <br />Please report MDLs, PQLs, and Truce, BC Labs -Tina Orcen 40 ml VOA: I <br />4100 Atlas Court 250 mi LPL: 2 <br />Sig a ure <br />0 <br />inatur <br />�� <br />Nitrate Nitrogen has n 48 -hr [SOLD TIME. Boh-wrield, Ca 93308 500 mi LPG: 3 <br />66 1-3274911 / Fx: 327-1918 I liter HDPL: 4 <br />Printed Nam <br />P�rytled ams <br />� <br />�J (g�Q $ <br />**** Incl m,p-Xylene �4c o-xyleno in 8260 results. Ship via UPS Acct 965376 500 mi glass: 5 <br />Lab Cauriar: 1 liter glass: 6 <br />I'MBC <br />Firm <br />h <br />G •(t, IL <br />Ross Dickey r+ 661-201-4171 2x6 els ring: 7 <br />glass jar: 8 <br />Daterrime o <br />D <br />�'1t„/�A+t+>-il- C.+�..--+ \/ tis [,'J"'V'Z_.s"'7•-fZ.i��i p�.�' �'LM 1'v.ArC �'� �. �`J . lei .F-s......�.. <br />