Laserfiche WebLink
,t <br /> CHAIN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM Page_of s <br /> d <br /> E y P.O.No: Direct Bili to the County <br /> c hQ6 180 Promenade Circle Suite 320 Sacramento Calle 95834 5-0aaw Lab: BC.Lnbs Baltersreid <br /> Project Name: Harney Lane LF,San Joaquin County Analysis Re uested y <br /> Ist Qtr 2013 Ground Water-Annual Al p a <br /> y Project Number: 139866 Oa7 K N <br /> a Report to: Sheila Richgels,Shaw Environmental , 7 <br /> -sheilo.richgels@slmwgrp.com> 916-565-4327 a. --I <br /> a CC Report to: Jody Rhondes,Shaw Environmentalo 0 y <br /> n <br /> o b <jody.riloades R shawgrp.com> 916-56 -4362 L) vi ; ° 5.o to Q <br /> wz Sampler's Signature: t= <br /> Oa m o <br /> 0 Q' D 2 A '1 <br /> a �— �d u m rn ov `f 4 ° REMARKS S 42 <br /> w� „ Sample 2013 LAB Sample von. L.LPE 250 mf 25nrot 500LPE ConlafnerT es <br /> p1 = 1.D. Date Time 1.D. Mntrix ` 5. <br /> Rcl NP ttxsat IIN03 r1No3 Preservations c is <br /> S - MW-1 11t4 water 7 3 1 1 1 7 A <br /> co <br /> CLW o -19 MW-2 1up water 7 3 1 1 1 ILit/ n!SjMO <br /> a <br /> n —3 MW-3 037 water 7 3 1 1co <br /> i I <br /> w MW-4 33 water 7 3 1 1 1 1RI 19-0111N <br /> eD MW-5 �Z water 7 3 1 1 1 l °* <br /> rn <br /> MW-6 l7J water 7 3 1 i ! 1 <br /> 'I7 <br /> N Field BlnnlcN a DID SS <br /> t� water 2 2 +® <br /> v o Tri Blank ^1119 water 2 2 <br /> mit 0 <br /> y-n RELINQUISIIED BY RECEIVED BY RELINQUISBIM BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS N <br /> x$ A I REQUIREMENTS X 1. Routine Reporl <br /> rn F Slime Si [tire / Sign�lgrc t Signature 24 hr 49 hr _5 day It. Report(includesDUP,MS <br /> W. 3 C (,� X amnrinN(-10-]4rvarking day.) MSD,as required,maybe <br /> 8 I'ri ii�N"nmc rbt d Nom Prin�e Name Printed Name '.A4.Vere.:Praamimry n..di. charged as samples) <br /> ,�o p /Qf/L G O ��1-3P,avkaPnsrram.:.ayna>uk. IILData VnlidntionReport <br /> W 'L Firm Finn Pirm )) Finn R.'. IM Aepnn D.1.1 (includes All Rnw Data) <br /> Slunv Environmental 43 c- 5 X RIVQCD <br /> y Dnfe/1'1me IL—L-13 Dnlefrime Dnlerrime;L11r19i I Dnlefrime (MDLs/PQLsfTRACEH) <br /> a RELINQUISHED BY RECEIVED BY Special Insh�ullons/ ommenta: <br /> 3 BC Labs-Tine Green <br /> Signafur Signature Please report h1RL's,PQL's And Trace. 4100 At1As COtin <br /> g Nitndc-Nitrogen hits it 48-fir bold time. Balcersfield,Co 93308 <br /> 'm Printed Name Printed Nam 661-3274911/Fx:327-1918 <br /> g 'o �E 3h) v „c Mt, J6 Ship via UPS Acct 965376 <br /> n Firm Firm ^ BC Lab Courier: <br /> c <br /> a' !ZLJ Lr> 1?J�/ EDDs to<suaan-tvnlennan(alshawgT.com> Roar:Dickey nQ 661-30I.4171 <br /> y Dafelrintc` 'L Dulefrime q-\ Mud <br /> 8 i - <br /> O. <br /> 0 <br /> -e P <br /> al <br /> M <br /> !D <br /> W <br /> O <br /> A <br /> f0 <br />