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2795 2nd Street,Suite 300 <br /> KI FF Davis.CA 95618 C <br /> Analytical uC Lab: 530.297.4800 SRG#/Lab No. 2 Page _ of _ <br /> Far. 530.297.4802 <br /> Project Contact(Hardcopy or PDF To): California EDF Report? ❑Yes Q No Chain-of-Custody Record and Analysis Request <br /> Matt Cohen <br /> Company/Address: Sampling Company Log Code: Analysis Re nest TAT <br /> 3050 Industrial Blvd,West Sacramento,95691 PLEASE CIRCLE El Number: Global ID: METHOD <br /> (916)372-1434 0 12 hr <br /> m _ <br /> Fax Number: EDF Deliverable To(Email Address): c $ <br /> 916 372-2565 <br /> Project#: P.O.#: Bill to: _ `m ii A S I $ 24 hr p <br /> 9041.01P Wallace Kuhl&Associates w <br /> i a o n w 7 <br /> Project Name: Sampler P'nt Name: a o w o w — ❑ <br /> City of Manteca UST Removal Don Up raff 48hr J <br /> Sal mp r Si :' `w Oz N w N o n a_ o m ° w <br /> iu a '3 43 u' m <br /> Project Address: Sampling Container Preservative N�atrir, w o ° ;, ¢ a $ a ¢ a 8 $ a ❑ <br /> a w <br /> 320 Center Street m m o Q w w o w " N a N a m 72hr <br /> Manteca, California m a ;, = o „ „ o = a a w a x <br /> O o d W m i 0 0 0 O <br /> m w rn m N m v m n u F c ❑ <br /> E 'w a. H �° O c =' w 2 v n m S x n w o 2. 1 Wk <br /> Sample Designation Date Time a rn Q. c7 1— 2 = zo rR ¢ E m a <br /> S-1.4!� .. 3/4/2011 If GS x x x x x x x x x x x 48 hr rJ <br /> S-2 3/4/2011 II x x x x x x x x x x x 48 hr 2 <br /> S-3 3/4/2011 It 1'� x x x x x z x x x x x 48hr 03 <br /> Relin ished y: K Date Time Received by Remarks: <br /> Imquished by Date Time Received by. <br /> linquished by Date Time Re eiv by L/pbor ory: r For Lab Use Only: Sample Receipt <br /> 3N Temp°C nitials Dale Time Therm.ID# C-lem JNNo <br /> U I{ Yes <br /> DisMixtien. While-Lab'.Pink Originator <br /> Rer. 061708 <br />