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X <br /> ro <br /> -0 —:<0 <br /> e <br /> m <br /> a <br /> CD <br /> ace Ay Form 0- 3 cb <br /> s ANALYTICAL SERVICES 4100 Atlas Ct.-Bakersfield,CA 93308-661.327.4911-Fax:661.327.1918-www.pacelabs.com 1111111111 -.-0 <br /> client: Arcadis U.S. Inc Project#:30274343.01 2gp203iD Page of �a <br /> 4 _ a (a............o. Ct m <br /> o Attn:Dalia Rumani Project Name:Forward Landfill o Y z <br /> H di E e Also send results to Zina Kamal(Zina.Kamal@arcadis.com), sz m (� <br /> 0 0 Street Address: 18401 Von Karman Ave,Unit 300 eiD# 1026 Extraction Wells z Elena Strom(elena.strom@arcdis.com),and Kyle Power n N <br /> o ^ ° Sampler(s)Nam M o y O <br /> x o City,State,Zip: Irvine, CA 92612 Print \ z $ (kpower@lrihydro.com) O e <br /> m <br /> e Phone:805.234.1390 Fax: A ai �, 0 <br /> o a ° @ " Sample Matrix Result Request -Surcharge CCD <br /> Email: dalia.rumani@arcadis.com o 0 <br /> N m J STD 5 Day"" 4 Day- <br /> STD �. <br /> Work Order#: U m 2ai <br /> r 3 Day- --j 2 Day" -�1 Day- •* <br /> m , r `o y ci to m = � Rush requests must be approved c <br /> �- <br /> � N L m` O o m <br /> m aSampledSampledU U o > o y 6 c9 3 aver Notes <br /> VcO <br /> D o <br /> o N <br /> m-7 a to <br /> a <br /> WO w o N <br /> W m `0 O <br /> y � W <br /> � ❑ O <br /> rn< s <br /> CO G x a <br /> 0 <br /> 07 <br /> 0 <br /> Do aJTInN <br /> N <br /> " a THOR . <br /> a1 S <br /> v <br /> W o r+ N 2 O P S <br /> N ^ �• <br /> Vax C12. 13 ME Alc COT <br /> Co <br /> EL <br /> ID <br /> :v <br /> m M. <br /> EDF Re i Gaotracker Global ID <br /> ® same as above ❑X Yes ❑No <br /> oClient: ForwardLandfill 1.Rel' is De Time 1.Recel y Date rime <br /> -------------- 16.d 9 �C <br /> _ Address:9999 S.Austin Road --- 1600 <br /> System# .RI s d By Date Time 2.Received By Date Time <br /> a city: Manteca state CA zip 95336 y <br /> �. (Needed for CUP) 7„S l.L[ <br /> Attn: Osvaldo Cordero-2 -23 -9622 V 9 b I c J <br /> o GISXey❑well star❑ 3.Relinquished By Date Time 3.Received By Date Time <br /> 2 P.O.#: <br /> Pace Analytical Bakersfield does not accept samples containing radioactive material above background levels. Samples containing radioactive material must be disclosed prior to receipt.Any samples suspected <br /> of containing radioactive material above background levels will not be accepted and will be returned to client. <br /> o' <br /> N <br /> CD <br /> (D <br /> W <br /> O_ <br /> N <br /> A <br />