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Stockton Diesel Spill Lincoln, CA 95678 Excelchem Laboratories, Inc. 1135W Sunset BNd Suite A Excelchem All Rocklin, CA 95765 ..;------ <br />Laboratories, Inc T f Ph - 516-543-4445 Fe. 916-543-4449 <br />CHAIN-OF-CUSTODY RECORD AND ANALYSIS REQUEST <br />Project Manager <br />14 b k " ?Ili\ <br />Phone it <br />ii (' -)Q1-331 (a' — <br />Electronic Data Deliverables Request: <br />PDFIStandard Report <br />Email Address: <br />arvi ii(," Fax#. — EDD <br />Geotracker ,,1-,,,,, ;DI <br />itko 1111'4 1"u"SC <br />Company/Address FIN- ' ( 0 iq <br />./() ?(LSI'l(SC 19, L <br />Other _j Project NumberiP Oh <br />1109337-(( ANALYSIS REQUEST Page of Billing Address <br />5 04 C <br />Project Location - <br />/till, 1 I4 WC: ri, <br />J 11'c E. Itol (A !Requested TAT Bin# <br />Due Dale <br />Project Name <br />Orio r%C5(1 5(011 <br />Sampler Name and <br />4/11X111''' <br />'Method <br />Preserved <br />Srgnature <br />Work Order: <br />Matrix <br />x <br />L, <br />t <br />ta <br />t Time <br />LAB USE <br />ONLY: <br />Sampling Container <br />ID Date 'N./CJA > ili <br />`±i u) <br />Sample <br />0 co, <br />J 0 [PLASTIC o <br />5 <C u-' NONE/OTHER [WATER 8 u) AIR SI Aw(t '2'1-1 I 2-(-0 i'. /'' 4, v( )( <br />5,7 t{ .7-2,-( (i ej /-. 7( ,X. K )(‘ X\ . <br />207150 „ ,IF i , , <br />Relinquished by - ,saarr and err* Date Time Received by. isogn krep.) <br />JhrOt <br />Remarks/Notes: <br />Lialii-ed SanApte.Nolume. rfOr WrLiti SaMP kk. i /2-Lt <br />Relinquis by i sign and ,i, Date Time Received by Laboratory. ,.7 deem <br />-Li 1U4t1A 1/7N6 1Ltae <br /> Laboratory Representative