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X <br /> CD <br /> 0 <br /> e <br /> a c3, <br /> N s Ce� Chain 0 z <br /> 1 -} r z G of Custody Form 3 <br /> ANALYTICAL SERVICES 4100 Atlas Ct.-Bakersfield,CA 93308-661.327.4 11-Fax:661.327.1918-www.pacelabs.com c z y <br /> S. <br /> Report To: fA D <br /> Client: Arcadis U.S. Inc Project#:30274343.01 ° r <br /> Page-.�_of� <br /> o Attn:Delia Rumani Project Name:Forward Landfill o z a Comments: z \ <br /> cSee Arcadis Attachments A and B for VOC and DissoWed Metals Q m r� <br /> .1 p Street Address: 18401 Von Karman Ave,Unit 300 BID# 1Q26 Groundwater Monitoring Wells -° H E U) = n C J <br /> O o M v 0 Diss Metals=AJ,Sb,As,Be.Be,Cd,Cr,Co,Cu,Fe,Mn.Mo,Ph.Hg,Ni,Se.At,TI,Sn,V, <br /> o Sampler(s)Name N o Zn-Not Filtered O \0 <br /> D City,State,Zip: Irvine, CA 92612 Printed: y rn g a m 2 N U Also send results to Zina Kemal Zina.Kamal arcadis.com Elena Strom <br /> Phone:805.234.1390 Fax: o = (elena.slmm arcadis.com),and K P—(k )'j @ ye (power@trihydro.com) <br /> C) �. Z ni y N o Email: dalia.rumani@arcadis.com o M m m o Sample Matrix Result Request ""Surcharge 0 <br /> N O Y "o 2 G c m " J STD l 5 Day.. -]4 Day„ D. <br /> Work Order#: C , z a 10D <br /> 5 L �> co a� a _ a m m m) <br /> vDt " ? Y > d : > n3Day" 2Da <br /> 1 Y" 11 Day <br /> - <br /> 0Sampleeption • v m 0 a m 0 m =_ Rush requests must be approved <br /> r� N O U U H O H O [R r o c7 3 Other Notes <br /> m' a <br /> r°o a I� —y�„ O <br /> � <br /> 4 n 1 <br /> to <br /> a <br /> O00m - <br /> '' G 1Z v <br /> w �, x <br /> - LL <br /> eZ fl7 <br /> CD <br /> 1 Iz 13017 <br /> _6 1,5qI 7Lf7Lo <br /> X� <br /> a <br /> 6 <br /> m <br /> LHQ-R <br /> W p n <br /> N rJ <br /> V o +x <br /> O 5' <br /> W <br /> ^ O i <br /> EL <br /> N � � <br /> T ° • ® Same as above EDF Required Geotracker ❑Yes ❑No Global ID <br /> s Client: F rw rd Landfill <br /> 0 d ---------------- 1.Relinqui h Date - Tim 1.Received By Date Time <br /> Address:9999 S.Austin Road - t-7( �. o-ZG <br /> 0 o city: Manteca state CA zip 95336 System# 2.Relinquished By Date Time 2.Received By - Date / Time <br /> (Needed for CLIP) ,�/: �h, �l 'g e Vu , 11342[ X1`5 <br /> Attn: do Cordero-209-235-9622 'Ko •'�"++�t V (/j U J <br /> a a, GIS/Key❑Well Star❑ 3.Relinquished By Date Time 3.Received By Date Tune <br /> a . <br /> P.O.#: <br /> ry 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 /> 0 <br /> N <br /> O <br /> (D <br /> Cn <br /> O_ <br /> co <br /> A <br />