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1.0596 VD '-lolem.IN/ 09t/Z '0N aleoLliPeD dV13 0 <br />0 <br />0 <br />—n <br />0 <br />(i) <br />0 IIReceived by: Ili:Relinquished by: Received by: Relinquished by. liReceived by: 11Relinquished SigsLature I Lab ID*/ I Sampler Printed: -41,5e 4-iee6- ISampler Signature: 91.— - I Report Attention: It I_ 6. IlProject# / PO# / Global—ID: -5c, A../ /4 5 -r - roc er 4114 I Phone / Email: ik2 SV P &tE I City/State/ZIP: 4/6",_ e 4 rt Address: I Qç rfljk?5 6 1.4- o 6 ge Customer: 11 6 t ^N N. l'Ill.N) <br />I <br />V\1 N. <br />64 \ <br />t <br />--• <br />z <br />ON \I\ <br />- <br />* k <br />i SAMPLE ID -- 1\ <br />e.1 <br />J DATE, <br />-C, <br />-NA TIME <br />II <br />lk,14 <br />c. 1. <br />r, <br />IN t'l r.., ^i Printed Name ,., <br />, ± <br />LP\ <br />k <br />—C <br />Z. DESCRIPTION/LOCATION <br />0 SAMPLE TYPE <br />composite(c) discrete/grab(d) <br />SAMPLE MATRIX <br />soil(s) liquid(I) vapor(v) other (o) <br />BTEX/MTBE/TPH-GAS 8021/8015 REQUESTED ANALYSES 1 <br />A <br />' <br />vz, <br />--i <br />cY) <br />TPH-DIESEL / MOTOR OIL - 80158 <br />TRPH 418.1M / SM5520C & F <br />' <br />Ilk <br />1).....: <br />, <br />01 company Nart16-, <br />Oxy's / EDB / DCA by 8260 <br />8260 Volatiles- full list <br />X PCBs - 8082 <br />Electronic Deliverables (EDF) Turn Around Tim< 24 Hour 48 Hourf--- , 3 Day 5 Day (Normal) I Special:_ NUMBER OF CONTAINERS otai nurnoer at containers I submitted to the laboratory I OBSERVATIONS/REMARKS Notes: DD c) I 0 Method of Shipment: