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PQM20H TIMRO-M CHAIR OF CDSTODY iggpi <br /> Analytical Laboratory <br /> 3935 N.Coronado Ave,Stockton CA.95204 Phone:(209)477-8105 Page Of <br /> 1 1 <br /> Work Order No. 2011904 <br /> lent ame Project Name Requested Analpes EVU Requirement Requested Turn Around <br /> UniFirst Corporation Effluent(1 per Week&2 per We Excel EDD ❑ <br /> Client Contact Project Number ❑ Rush requests subject to <br /> William Geary UFC Geotracker q a <br /> additional charge. <br /> N DWO upload ❑ <br /> Address Project Description Q OA/OC Rush requests subject to lab <br /> 819 N.Hunter Street p ID Regulator ❑ approval. <br /> City PO Number Ln `~ <br /> N Ur' State Specify: <br /> Stockton <br /> o <br /> State/ZIP Shipped By N :: Specify: Standard(days) <br /> CA,95205 ~ <br /> Phone Fax Matrix 0 = Global ID Expedited(days) <br /> .ti Q <br /> (209)941-8364/(209)941-4022 sediment 3 Other 71 N <br /> Sampler Sampler atu a Potable i Soil C <br /> 11 "i System ID Due Date <br /> � O <br /> +i n Waste W❑ Surface m O = <br /> reservation b <br /> Sample Type Matrix Container laboratory Work Order No./ <br /> Laboratory Work Order No./ID Sa plee��d Date Sam pled Time Code Code Count a::l d::3 Sample Conclitioniemperature Sample to <br /> Automatic 24 hrs Composite Sampler '1 Z V C W 1 1 0 di W 0 -Q <br /> Final Effluent at Discharge Flume G W 1 0 1 <br /> i <br /> I <br /> Relinquished By I rate4lme Received y Dated SAMPLING <br /> 66«JJ6 Special Instruction <br /> Date/r,me Receiv By Date/Tme COMPOSITE SAMPLER SETUP, <br /> Relinquished By Sampler(s) <br /> Relinquished By Date/Tme Received By Date/Tme Date Setup 2 Time ►► (JU <br /> Cooler Numbers and Temperatures comment: <br /> Matrix codes: W=Waste water Preterit.Codes: 1=Store cool at 4°C,3=Add HCI to pH<2;Store cool at 4°C <br /> cont.Codes a=1L Poly-Unpres,d=1L Amber-HCI <br /> Page 18 of 21 <br />