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General COC <br />MAI Work Order # <br />® McCAMPBELL ANALYTICAL, INC. <br />1534 Willow Pass Rd. Pittsburg, Ca. 94565-1701 <br />WO Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />v4-ww.rnccam0bell.corn main(c-u.mccarn bell.com <br />CHAIN OF CUSTODY RECORD <br />Turn Around Timc: I Day Rush 2 Day Rush <br />3 Day Rush STD Quote # <br />1 -Flag! M171. I ESL • Cleanup Approved <br />Dry Weight I Bottle Order # <br />Delivery Format: PDF GeoTracker GDF <br />I EDU I Write On (DIV) Detect Sununar� <br />Report To: Peng Leong Bill To: Same <br />Analysis <br />Requested <br />Company: ICES <br />Cc <br />°� <br />© <br />L <br />x <br />cu <br />- <br />a7 <br />3 <br />;= <br />z <br />a. = <br />i� •r. <br />s <br />o <br />a <br />w <br />x <br />a, `-� <br />(- ;� <br />_ <br />c= <br />E- s <br />` <br />c <br />L_ <br />a s <br />;, <br />c L <br />l.• U <br />c <br />e <br />e <br />� <br />o <br />e <br />¢ <br />Wm <br />- <br />t <br />J <br />¢ <br />o~o <br />¢ <br />°_ <br />pip <br />4 <br />¢ <br />W <br />a <br />_ <br />n <br />= <br />U <br />N <br />= <br />o <br />Ir <br />u <br />a <br />m <br />7 <br />f <br />a <br />= J <br />A <br />a <br />Q} <br />J <br />tJ <br />c <br />Address: 3300 Powell Street Suite 109 Emeryville CA 94608 <br />Email: alphaenv222@gmail.com Tele: 510-652-3222 <br />Project Name: Project #: ICES 9315 <br />Project Location: POUx <br />Sampler Signature: <br />SAMPLE I <br />Location 1 Field Poing <br />Samplin, <br />V <br />_- <br />Matrix <br />Preservative <br />Date <br />1 inle <br />K-1 <br />3!1122, <br />1 <br />Soil <br />• <br />• <br />K-2 <br />311122 <br />1 <br />Soil' <br />• <br />• <br />K-3 <br />3/1122 <br />1 <br />Soil <br />• <br />• <br />K-4 <br />311122 <br />1 <br />Soil <br />• <br />• <br />K-5 <br />311122 <br />1 <br />Soil <br />• <br />• <br />MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause immediate harm or serious future health endangerment as a result of brief, gloved, open air, sample handling by MAI staff. <br />Non -disclosure incurs an immediate 5250 surcharge and the client is subject to full legal liability for harm suffered. Thank you for your understanding 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 default to metals by E200.8. <br />Comments / Instructions <br />Please provide an adequate volume of sample. if the volume is not sufficient for a MS/MSD a LCSILCSD will be prepared in its place and noted in the report. <br />Relinquishc I Company Name Date Time Received B1 1 Cot pany Name Date Time <br />!! <br />� Jd <br />Matrix Code: = rinki ater, 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=HCl 3=H'-SO4 4=HNO3 5=NaOH 6=ZnOAc/NaOH 7=None <br />Temp -161, X Initials <br />Page 16 of 17 <br />