Laserfiche WebLink
Frontier Analytical Laboratory FAL USE ONLY <br />5172 Hillsdale Circle <br />W M El Dorado Hills, CA 95762 Laboratory Project Nc <br />ANALYi}CAL LABQRAt0AY <br />Tel: 916-934-0900 Temperature;. <br />Fax: 916-934-0999 <br />Chain of Custody <br />www.frontieranalytical.com <br />Please Print in Pen Page 1 of - <br />CLIENT INFORMATION <br />INVOICE INFORMATION (if different from client info) <br />PROJECT INFORMATION - <br />Company Name: Brusca Associates, Inc. <br />Company Name: Same <br />FAL Quote #: 3310 <br />Contact Name: Joe Brusca <br />Contact Name: <br />P.O. #: <br />Address: PO Box 332 Roseville CA 95661 <br />Phone: 916-677-1470 Fax: <br />Address: <br />Phone: Fax: <br />Project #: / _?7 — 007— <br />Project Name: t!, 't 1+4orTt�- q -r _ P &Vr'( <br />Email: 'brusca@bruseaassoeiates.com <br />Email: <br />TAT (business days): 15 M10 5* 3* (J one) <br />* FAL must a ree with price and RUSH TAT in writing. <br />REPORT INFORMATION <br />REPORT DISTRIBUTION email only is preferred)ADDITIONAL INSTRUCTIONS <br />Report Level: Q I/II Li III 0 IV <br />Hardcopy <br />F—JEDD: Q FAL Basic ® Geotracker <br />CD (.pdf including EDDs if requested) <br />F7Other: Custom: Contact FAL <br />El Email (.pdf including EDDs if requested) <br />California State Drinking Water Form <br />System #: Source #: <br />"CONGENERS **TEQ <br />Employer: <br />,,, <br />1998 WHO -TCDD onlySampler: <br />N <br />0 <br />0, 'i b <br />00 <br />1 2,3,7,8-TCDD/F only Q✓ 2005 WHO <br />Sample ID Date <br />Time Matrix ` ® ¢ ¢ Q <br />¢ a ✓ PCDD/F (Cl' -Cl') Other <br />..Collected - w <br />w w w O Remarks <br />1 V t ( iv <br />I zz- 5o3 <br />2Zo <br />t.Z <br />3 VSZ2 <br />4 U S Z <br />i. <br />5 <br />Z. <br />6 <br />7S 3 <br />i z'sx. <br />8 S I' <br />9 <br />10 <br />11 <br />12: <br />13 <br />14' <br />15 <br />Samples will be disposed of 90 days after sample receipt unless other arrangements have been made and agreed upon in writing. <br />Re6.qq1Jhed b Si nature and Printed Name <br />at <br />Time ` e ei el b : (Sir—nature <br />and Printed Name) Date Time <br />tf <br />3: <br />r <br />Client understands that all terms described in the proposals, quotations, and/or the general terms provided in the current FAL price schedtff6Mt4PUe1td l - ttV <br />FAL reserves the rights to terminate its service or withhold delivery of reports, if in FAL's sole discretion the terms of the project have been broken. <br />CD <br />0 <br />S.. <br />0 <br />0 <br />O <br />n. <br />C9 <br />0 <br />