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General COC MAI Work Order# 21 N �� <br /> McCAMPBELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd.Pittsburg,Ca.945 65-1701 Tum Around Time:l Day Rush 2 Day Rush 3 Day Rush STD 0 Quote# <br /> �O Telephone:(877)252-9262/Fax:(925)252-9269 I-Flag/MDI ESL Cleanup Approved Dry weight Bottle Order# <br /> www.mccampbell.coni main mccam bell.com Delivery Format; 111W GeoTracker EDF EDD Write On(DW) Detect Summary <br /> Report To:Daniel Kramer Bill To:Daniel Kramer Analysis Requested <br /> Company:Petralogix Engineering <br /> Email:dkramer@petralogix.com <br /> Alt Email:tscheflner@petralogix.com Tele: 209-770-0731 _ <br /> Project Name:SSS/NLS-S Koster Road Project#: p <br /> Project Location:33503 S Koster Road PO# tCV <br /> CD <br /> Sampler Signature:—T` LLI W <br /> �. Z <br /> SAMPLE ID Sampling 17] <br /> Location/Field Point o Matrix Preservative 00 Q <br /> Date Time p z F-- <br /> DW <br /> DW 9 7 �I IO 30 5 DW <br /> MAI clients MUST disclose any dangerous chemicals(mown to be present in their submitted samples in concentrations that may cause iLly ie iatcI nor serious future health endangerment as a result of brief;gloved,open air,sample handling by MAI staff. <br /> Non-disclosure incurs an immediate$250 surcharge and the client is subject to full legal liability for harm suffered.Thank you far your delan and for allowing us to work safely. <br /> *if metals are requested for water samples and the water type(Matrix)is not specified on the chain of custody,MAI will fau] to tats by E200.8. Comments/Instructions <br /> Please provide an adequate volume of sample.If the volume is not sufficient for a MS/MSD a LCS/LCSD will be pryfwedlin is pfaci and oted in the report. <br /> Relinquished By/Company Name Date i I111 I Rec ed i3 / mpa Name Dafe Time <br /> Matrix Code:DW=Drinking Water,GW=Ground Water, WW=Waste Water,SW=Seawater,S=Soil,SL=Sludge,A=Air,WP=Wipe,O=Other <br /> Preservative Code: 1=4°C 2=HCI 3=H,SO4 4=HNO3 S=NaOH 6=ZnOAc/NaOH 7=None Temp Initials <br /> V Page_of_ <br /> Page 10 of 11 <br />