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2795 Second Street, Suite 300 Calscience -11-1921 <br /> KIFF Davis, CA 95618 7440 Lincoln Way <br /> Lab: 530.297.4800 Garden Grove, CA 92841-1427 <br /> /analytical LLC Fax: 530.297.4808 714-895-5494 COC No. 83346 Page 1 of 1 <br /> Project Contact(Hardcopy or PDF to): EDF Report? YES Chain-of-Custody Record and Analysis Request <br /> Jennifer Worsley <br /> Company/Address: Recommended but not mandatory to compf3te this section: <br /> al <br /> Sampling Company Log Code: SIRC Analysis Request <br /> Kiff AnalyticDue Date <br /> Phone No.: FAX No.: Global ID: SL0002050099 <br /> 530-297-4800 530-297-4808 04 <br /> Project Number: P.O. No.: Deliverables to(Email Address): O a <br /> 211602385.500.0800 83346 inbox kiffanal tical.com N E <br /> 0 <br /> Project Name: Container/Preservative Matrix FO oM N <br /> L <br /> Parcel 2A <br /> Project Address: Sampling o ° E L <br /> s N O <br /> c7 LL <br /> Sample E , o z <br /> DDesignations <br /> Date Time J 9 _ <br /> GW-EFF 11/28/12 09:25 2 X X X <br /> I IT LL-iR I I I I I <br /> Relinqui ed by: Date Time Received by: Remarks: please provide EQUIS. <br /> (( Poo <br /> Relinquished by: Date Time Received by: <br /> Relinquished by: Date Time Received by Laboratory: Bill to: <br /> otJ'�i2G i�tt ,v i� Accounts Payable <br /> ,..,...,,iients F <br />