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�i <br /> 2795 Second Street, Suite 300 Calscience 1 12-12-1558 <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. 83635 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 complete this section: <br /> Klff Analytical Sampling Company Log Code: SIRC Analysis Request Due 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 83635 inbox _kiffanalytical.com N E <br /> 0 ti o <br /> Project Name: Container/Preservative Matrix U) N v, <br /> Parcel 2A N <br /> Project Address: Sampling c L <br /> _ a) o <br /> U LL <br /> Sample E o 0 <br /> ti <br /> Desi naon _ <br /> g Date Time <br /> GW-EFF 12/21/12 10:20 2 X X I I X <br /> RelinquiaW by: Date Time Received by: Remarks: Please provide EQUIS. <br /> Relinquished by: Date Time Received by: <br /> Relinquished by: to Time Received by Laboratory: Bill to: <br /> ,.� �— Accounts Payable <br />