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h- CHAIN OF CUSTODY <br /> 2105 Lundy Ave,San Jose,CA 95131 PED EX T—ki,mBoone Drd.r.W.19 <br /> �� (408)588-0200 FAX:(408)588-0201 Accatestoeot.x Aeeutest NC Job 4:C C2 I I Q <br /> L A B O R A TCT R I E S J CJ <br /> Cl <br /> len Reporting norma tun Project Information Requested Analysis Matrix Codes <br /> Company No / � VIVI.w.0—ter <br /> EP �A I-10Project Mama: <br /> cw—,JW— <br /> Add.. <br /> rwrawale.Address Snort sw-surtacewater <br /> �5� WiIs�la 910 15� fdo a 1 4 r assed <br /> City Stafa Zip City <br /> LDSH .'12� C/ �'IbC1l� 3J otos <br /> VJP-wipe e� <br /> Project Contact P(ej.et IF <br /> 1'��t/i ,� � LIQ-Non-a9ae.us Liqud <br /> Phan.# 77 q rp�`< 1111I /jf::% <br /> smeplere'.Ph Client Purchase Order C5 ) i Dtv-Dd�*kirg tValer <br /> Accutest Collection N? Number of preserved Bottles <br /> Sample I#ol w $ LAB USE ONLY <br /> ID Sample ID/Field Point/Point of Collection Date T— Sampled by ntatdX boN.s g g 1 E <br /> I 5g -A3 Waltz 1,o31,ow 3i- Se i 1 <br /> s _2,Lv )-� <br /> /o to 5S t <br /> 513 S 70 )Io <br /> I Ito <br /> 1115 <br /> �2 3 <br /> Turnaround Time(Durm..days) Data Deliveab a lnfomlabon Comments/Remarks <br /> Approved By:/Bata: <br /> Cemmercia!"e"-Results with OC summarte<. <br /> Standard TAT � `=G REOT1-Level 3 data package <br /> 3 Day(applicable markup) FULTt-Level 4 data package <br /> 2 Day(applicable markup) EDF for Geo sacker =EDD Format <br /> I Day jepplicabte markup) Provide EDF GIob.I ID <br /> Provide EDF Logcod.: <br /> Emergency T/A data available VIA Lablink <br /> Sample Custody must be documented below each time s4njpr.change possession,lost.1 us ler clotivery. <br /> Relinqulx dbyy SamplerBale Time: Recelvetl Rommashed ey: Date Ti— Received By: <br /> 1 Ghn ty tt(LE�I a� z 11 ,7W 2, <br /> Relinquntud by: Date Time: Reo.iv By: RBlinqulehed By: cute v e: ReceiYed By: <br /> 3 3 4 4 <br /> Rennq.NFW by: Data Time: Received By: cuutody Seui# Cooler Temp <br /> 5 5 on Ic Y N Number of coolers <br /> C31148: Chain of Custody <br /> Page 1 of 3 <br /> ■ 46 of 80 <br /> R��tJTt=�T <br /> C31148 <br />