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SHAW oIo)�crM <br /> VLAFFOR LABORATORY USE ONLY <br /> Advanced Technology Method o1 Transport Sample Condition Upon Receipt <br /> Laboratories Batch# D 0 # Walk In ❑ 1 COOLER TEMP C_(26) 5 SEALED Y❑ N❑ <br /> Courier ❑ 2 CHILLED Y❑ N❑ 6 #OF SPLS MATCH COC Y❑ N❑ <br /> 1510 E 33rd Street p O# UPS ❑ <br /> Signal Hill,CA 90807 FED EXP ❑ 3 HEADSPACE(VOA) Y❑ N❑ 7 PRESERVED Y❑ N❑ <br /> (310)989-4045•FAX(310)989-4040 Logged By Date Time ATL ❑ 4 CONTAINER INTACT Y❑ NO a CONTR LOT# <br /> Client GE OCON ENVIRONMENTAL - SACRAMENTO Address 3235 Sunrise Blvd #6 TEL ( 916 ) 852 9118 <br /> Attn la,> (,.,JCity Rancho Cordova State CA Zap Code 95742 FAX ( 916 ) 852 9132 <br /> Project NameProject# 5 Stu()��-f Sampler (Pn ad Name / (Synazui <br /> x/)010 10, Lr <br /> Relinquish r3 ) ^ Received by Isynee..ad anew Nam.) Date C Time �3 <br /> owji <br /> Relinquished by tsgnaen.aed 'aa.ena.,.. Received by (sgmkv.ab am. ate jNd Time <br /> Relinquished by (sy�ww,..w P,M.d Nan») Received by iswAk..and Pnna.d Nh M Wink Date Time <br /> I hereby authorize ATL to perform the work indicated below Send Report To peas InstrucuonsrCommenis <br /> Unless otherwise Project Mgr,Submitter Ann C7- <br /> requested all <br /> samples will be Date_ i f Co <br /> disposed 60 days Prmt Name T1014 <br /> aper receipt Address <br /> Sionaiure City State Zip <br /> SHIP TO LAB SHIP TO LAB SHIP TO LAB Circle or Addu CIRCLE APPROPRIATE A I <br /> (SUB CONTRACT) (SUB CONTRACT) (SUS CONTRACT) U <br /> Analysis(es) c�U 01 P MATRIX z RTNE ❑ <br /> TEST TEST TEST Requested y O <br /> ATL s ATL a ATL ii j a x 0ra�v(i AWQCB F-1DATE DATE DATE Fa R` h3 GO r, S, 3� e a W[P El <br /> CLIENT 10 CLIENT 10 CLIENT I D m°� �� k�m" `o UV�����amy V� Q � NAVY El <br /> LAB USE ONLY am"` ° ��4 .,�, w CT ! j <br /> T Saictt# Sample Description o �� m. p°� ^o �a� �4t has �o� `' o" Q 2 �� ¢ Container(s) w OTHER <br /> E Lab No Sample I D Date Time o °tip o� p h o o o o" ? �� TAT # Type I a REMARKS <br /> M p m e 0 3 oe o <br /> 2 !- ODI <br /> 2 <br /> M k/- .S- O CI�v <br /> Mn 5— �Cv 8 6 083 <br /> �J-a s-75 <br /> Sample Arcfiivelpisoosa Overnight Emergency Critical Pent Routine •TAT starts 8 a�n Preservatives <br /> D LaboratoryStandard TAT A=l s 24 hr B= Next workda C=�2 Workdays! D- orkdays E=7 Workdays ° ry�my 3smp�s H-HcI N=HNO S=H 50. C=4 C <br /> ❑ Otne <br /> ❑ Reiurn To Cortiainer T Des T=Tube V=VOA L=Liter P=Pini J--Jar B=Tedlar G=Glass P=Plastic M=Metal Z=Zn(AC)- O=NaOH T=Na.S-43 <br /> $1000 FEE PER HAZARDOUS SAMPLE DISPOSAL DISTRIBUTION White with report Green to organic Yellow to inorganic Pink to Biology Goid to submitter <br />