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A �� SaM� le ?) C'r'j ev�riso - � a ff - 66 7 3 <br /> General COC O 10 A -1 ke r 4-0 tl � d - <br /> r t r MAI Work Order# � � �`� ✓ <br /> ve htn Q T� ; —�— <br /> j <br /> ® McCAMPBELL ANALYTICAL,INC. CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd.Pittsburg,Ca.94565-1701 Turn Around Time;I Day Rush 2 Day Rush 3 Day Rus ',',<JSTDI I Quote4j <br /> Telephone:(877)252-9262/Fax:(925)252-9269 J-FI.gfMDLj I ESLI Cleanup Approved I --1-6,yWeightj I Bottle Order 9 <br /> wwv6.mccamnbelLeom main 1 mccampbell.com Delivery Format: I PDF GeoTackerEDFI I EDDI I Write On(D%)l I Detect Summary <br /> Report To: U7 r i c N LSA Ce h 0. Bill To: m r „f Analysis Requested <br /> Company: G roLb eO I h C- <br /> . <br /> Email: ;,tip 6i,` ; C. V'r" <br /> Alt Email: Tele: <br /> Project Name: �� _ ! ; F_ Project#: <br /> Project Location;' j,, ) ,•,,.; ;.,PO# <br /> Sampler Signature <br /> Sampling e <br /> SAMPLE ID - <br /> Location/Field Point Matrix Preservative <br /> Date Time <br /> LLL <br /> MAI clients MOIST disclose,any dangerous chemicals Imovm to be present in their submitted samples in concentrations that may cause immediate harm or serious fi,ture health endangerment as a result of beef,gloved,open air,sample hatrdting by MAI staff <br /> Non-disclosure incurs an immediate$250 stucharge and the client is subject to full legal liability for barn suffered.Thank you for your understanding and for allowing us to work safely. <br /> •If metals are requested far water samples and the water type(Matrix)is not specified an the chain ofcusiody,MAI will default to metals by E200.8. Comments/Instructions <br /> Please provide an adequate volume of sample.If the volume is not sufficient for a MS/MSD a LCS/LCSD will be prepared i "ace and noted in the report. <br /> Reiinqu isyd By 1 Company Name Da Time ed By Company Name Ic Time <br /> S ISI 1[1— 6l� 7 I <br /> s rs r 3 S <br /> Matrix Code:DW=Drinking Water,GW=Ground Water,WW=Waste Water,SW=Seawater,S-Soil,SL=Sludge,A=Air,WP=Wipe,O=Other <br /> Preservative Code:1=4eC 2=HCI 3=H2SO, 4=HNO3 5=NaOH 6=ZnOAc/NaOH 7=None Temp"-7, <br /> Initials <br /> Page of <br /> Page 13 of 14 <br />