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Chain of Custody - Work OrderRiverbank EDC <br />Reports and invoices delivered by email in PDF format <br />Lab No Pfl of <br />Report to <br />Company: <br />Analysis Request TAT TEMP °C <br />Ukiah <br />Livermore <br />PO Number: <br />Brittney mancilla@nwiec.com <br />Container & Matrix Other Petaluma <br />days <br />Purveyor Carlsbad <br />Sample Identification Time Notes I DDW Source Codes <br />21687 McBride Rd - well 1-15-26 9 15amn Will pay $55 by CC1xxXX <br />Relinquished by Received by Time DDW Write On EDT Transmission? <br />NON EDTState System Number: <br />If "Y" please enter the Source Number(s) in the column above <br />CA Geotracker EDF Report? <br />Sampling Company log CoOe <br />[Mileage <br />Central Valley Laboratory (2922) <br />9090 Union Park Way «113, Elk Grove CA 95624 <br />Bay Area Laboratory (2728) <br />262 Rickenbacker Circle. Livermore CA 94551 <br />San Diego Laboratory (3055) <br />2722 Loker Ave West Ste A Carlsbad CA 92010 <br />s <br />Preapproval <br />required <br />2603 Patterson <br />Rd Riverbank <br />CA 95367 <br />209-869-9260 North Bay Laboratory (2303) <br />737 Southpoint Blvd. Petaluma CA 949524 <br />a> <br />■C <br />6 < co <br />Corporate Laboratory (1551) <br />208 Mason Street. Ukiah CA 95482 <br />707 468 0401 (phone) <br />707 468 5267 (fax) <br />clientservices@alpha-labs com <br />< <br />CLe <br />0) <br />(L <br />3 <br />d <br />o <br />a. <br />Z) <br />o <br />a <br />a. <br />E ra <br />W <br />I <br />I s s o <br />o <br />u_ <br />O <br />E <br />3 <br />2 <br />3 <br />oI(/> <br />t/) <br />0 <br />5 <br />£ <br />O)I <br />tl <br />3 <br />CD <br />RUSH: <br />3 days o <br />48 hours <br />Standard <br />5 daysProject No: <br />"RepeaC <br />lab@environmental com <br />Field Sampler - Printed Name & Signature: <br />Mara Mansilla <br />Address: <br />Global ID <br />EDF to (Email Address) <br />Travel and Site Time <br />2603 Patterson Road. Suite #9 <br />Riverbank CA 95367________ <br />Phone/Fax: <br />i/7 <br />AJph.i ’ AnaMical t aber.'itonc* l'« <br />www.alpha-labs.com <br />Waters, Sediments, Solids <br />Brittney Mancilla <br />Address <br />Environmental com LLC <br />Attn: <br />21687 McBride Rd <br />Escalon. CA 95320 <br />Cell phone number: <br />(209)681-7611 <br />Email Address: <br />209-869-9260 <br />Email Address: <br />EDC (OTO) Client Info: <br />Company: <br />Brittney Mancilla <br />Date <br />iMisc Suppbes <br />OYes <br />h <br />Elk Grove <br />ONo <br />Project Information <br />Project ID: <br />Water Quality 5 Day <br />_____Sampling <br />Date <br />Signature below authonzes work under terms stated on reverse side. <br />5 <br />I <br />oYes O No