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= CHAIN OF CUSTODY <br /> ENVIRONMENTALwww .fglinc. com AND ANALYSIS REQUEST DOCUMENT <br /> Analytical Chemists <br /> Client Metal Finishing Solutions, Inc. Lab Number : TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Customer Number: 3018181 <br /> Address: Attn , Corev Dehl <br /> 1325 EI Pinal Drive <br /> Stockton , CA. 95205 m <br /> Phone: (925)872- 1263 Fax: <br /> V <br /> � @ Qi m <br /> Email Address : corev(@mfinish . com s41 <br /> Contact Person: Corev Dehl <br /> c� <br /> Project Name: Water Quality Analysis a Q O <br /> Purchase Order Number: O m = o Z <br /> Quote Number: > O � 2 = rL <br /> O vt <br /> � a r- <br /> Rush Analysis : El 5 Day E] 4 Day E] 3 Day ❑ 2 Day E] 24 hour m `m '� z �— <br /> Rush pre approval by lab (initals): E 2CL <br /> ^ � N <br /> m � F o gm Y o Q <br /> Electronic Data Transfer: No State Client Other: U =Q _ O rJ Z r N E E E <br /> U) c = 1-- H F <br /> Sampler(s) : C c c " � m V a CD <br /> o m d C7 m a�� <br /> .a tG z ? 6 C 2 z i % Q i LL ii <br /> Sampling Fee: Pickup Fee: o e U m 0 i o N a m � © hf ti <br /> 20 C11 <br /> 0 0 <br /> Compositor Setup Date: Time: m y F`- F m = r° r <br /> m ��, o m a ry , U) O rn oa v -o <br /> Samp Location Description Date Time g Z r c. G °.� m C` F m o iLD i D in <br /> Num Sampled Sampled <br /> 1 Tank l b t t70J G 4 G, P NP F F—F—F—� �� �������� <br /> 2 1 Tank Oil7 G 74 G, P [N' <br /> P FFFF'I'FFFFFFTFFFF[FFF' <br /> 3 Tank9 QI � 1� G, P NP FFFFFF'I I 'FF 77x-7777 <br /> Remarks quished Date: Time: Relinquished Date: Time: Relinquished Date: Time: <br /> w( � II �� 111 r4tc, 1 � tq 1161 I I01 <br /> Received By: Date: Time: Rece' By: Date: Time: Received By: Date: Tie: <br /> Corporate Offices & Laboratory Office & Laboratory Office & Laboratory Office & Laboratory Office & Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 563 E. Lindo Avenue 3442 Empresa Drive, Suite D 9415 W. Goshen Avenue <br /> Santa Paula, CA 93060 Stockton, CA 95215 Chico, CA 95926 San Luis Obispo, CA 93401 Visalia, CA 93291 <br /> TEL: (805)392-2000 TEL: (209)942-0182 TEL: (530)343-5818 TEL: (805)783-2940 TEL: (559)734-9473 <br /> Env FAX: (805)525-4172 / Ag FAX: (805)392-2063 FAX: (209)942-0423 FAX: (530)343-3807 FAX: (805)783-2912 FAX: (559)734-8435 <br /> CA ELAP Certification No, 1573 CA ELAP Certification No, 1563 CA ELAP Certification No, 2670 CA ELAP Certification No. 2775 CA ELAP Certification No. 2810 <br />