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PUMOo N TN%0 p 0 MAIN K USTODY <br /> Analytical Laboratory <br /> 3935 N.Coronado Ave,Stockton CA.95204 Phone:(209)477-8105 Page of <br /> 1 1 <br /> Work Order No. Zt 2 J b� —0/ <br /> Gent ame Project Name y <br /> Requested n Requirement Requested TurnAround <br /> UniFirst Corporation Effluent(1 per Week&2 per WeE Excel EDD ❑ <br /> Client Contact Project Number Geotracker ❑ Rush requests subject to <br /> William Geary UFC Dwoupload Eladdhionalcharge. <br /> Address Project Description <br /> OA/QC Rush requests subject to lab <br /> 819 N.Hunter Street O Regulator ❑ approval. <br /> 0 <br /> [Iry PO Number ry State Specify: ❑ <br /> Stockton <br /> Staff/Zip Shipped By Specify: Standard(days) <br /> CA,95205 Pick-Up <br /> Phone Fax Matrix 66 <br /> 0 Global ID Expedited(days) <br /> ti <br /> (209)941-8364/(209)941-4022 Sediment❑ other C <br /> Sampler Sampler S tur Potable Sell❑ System ID Due Date <br /> WILliam Geary ���4n LPiPi / wastew I surface❑ m <br /> reservation Coro <br /> Sample Type Matrix Contalner Laboratory Work Order No./ <br /> Laboratory Work Order No./ID Sampled Date Sampled Time Code Code Count b::I Sample Condition Temperature sample to <br /> Final Eff.Auto 24hrs Comp.Sampler C W 1 1 <br /> Relinquished ByDate�me Race, Date/Time SAMPLING <br /> f Special Instruction <br /> Date/Time Received By Date/Time COMPOSITE SAMPLER SETUP: <br /> Relinquished By Sampler(s) <br /> Relinquished By Date/Time Received By Date/Time Date Setup 2 Time _ <br /> Cooler Numbers and Temperatures comment <br /> Default Cooler at 4.7 PC <br /> Matrix Codes: W=Waste Water Preserv.Codes: 1=Store Cool at 4°C <br /> cont.Codes b=500 mL Poly Unpres <br /> Page 20 of 21 <br />