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CBM OF COSTODY 9PPINPKMOH T�10 0 0 � <br /> Analytical Laboratory <br /> 3935 N.Coronado Ave,Stockton CA.95204 Phone:(209)477-B 105 Page of <br /> 1 1 <br /> Work Order No. 2010405 <br /> ClientName Project Name Requested AnalysesRequirement Requested Turn w <br /> UniFirst Corporation Effluent(1 per Week&2 per We o w Excel EDD ❑ <br /> Client Contact Project Number NS w Geotracker ❑ <br /> Rush requests subject to <br /> Q o H additional charge. <br /> William Geary UFC W N N � DWQ upload ❑ <br /> Address Project Description N 0 Q OA/QC Rush requests subject to lab <br /> 819 N.Hunter Street �; ID Regulator <br /> approval. <br /> o <br /> City PO Number i� State Specify:-er 19 <br /> �. <br /> ca <br /> Stockton Z 2 <br /> 0 M Spe<rfy: Standard(days) <br /> State/Zip S = Q Q O <br /> CA,95205 Pick-up w w <br /> Phone Fax Matrix m v? = Global ID Expedited(days) <br /> 15 <br /> (209)941-8364/(209)941-4022 Sediment Other C -0 - ii I— <br /> ai UD <br /> Sampler Sampler Signature Potable Soil.: vj N ;a System ID Due Date <br /> in <br /> N @ cz <br /> nolan Lee Waste w surface Q m 2 M o <br /> reservaucn e <br /> Sample Type Matrix Container Laboratory Work Order No./ <br /> Laboratory Work Order No./ID Sa ted Date Sampled Time Code Code Count b::2 b::l C::4 d::3 Sample Condition Tempenture Sample ID <br /> Final Eff.Auto 24hrs Comp.Sampler K r!'•v V C W 1 0 1 0 0 <br /> Automactic 24 Hrs Composite(Monthly Metals) Q C W 1 1 0 0 0 �fl <br /> Final Effluent at Discharge Flume l v G W 3 0 1 1 1 ' <br /> Relinquished By Date a ReceiveDate/nme SAMPLING <br /> QO d B Special Instruction <br /> DatefrimeRe Wed By atefl-ime COMPOSITE SAMPLER <br /> Relinquished By Sampler(s) <br /> Relinquished By Date/time Received By Datefrime Date Setup ?-,me <br /> Cooler Numbers and Temperatures comment, <br /> Default Cooler at 5 2C <br /> Matrix codes: W=waste water Preserv.Codes: 1=Collect in methanol;Store cool at 4'C,i=Store cool at 4'C,2=Add HNO3 to pH<2,3=Add HCI to pH- <br /> cont.codes b=500 mL Poly Unpres,b=500 mL Poly HNO3,c=-250 mL Poly NaOH,d=1L Amber-HCI <br /> Page 14 of 21 <br />