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=cWM dPtu D*%EMQ r <br /> _, FOR LABORATORY USE ONLY <br /> ILA vanced Technology Method of Transport Sample Condiuon upon Receipt <br /> Laboratories Batch# DO # Walk in ID 1 COOLER TEMP C (2-6) 5 SEALED Y y IN❑ <br /> 1510E 33rd Street Cotner ❑ <br /> P0#O� UPS ❑ ' F'2 CHILLED N❑ 6 4OFSPLSMATCHCOC Y❑ N 0 <br /> Signal Hill,CA 90807 ( FED EXP ID 3 HEADSPACE(VOA) Y© NO 7 PRESERVED YEI NO <br /> (310)989-4045•FAX(310)989-4040 Logged By Date Time ATL 0 4 CONTAINER INTACT yN N❑ 8 CONTR LOT# <br /> Client G OCON ENVIRONMENTAL - SACRAMENTO Address 3235 Sunrise Slvd #6 1TEL ( 916 ) 852 9118 <br /> Attn LJ C'.J City Rancho Cordova State CA Zip Code 95742 1 FAX( 916 ) 852 913 2 <br />' Proled Name Project# Sampler P"ntadNanei 1:; <br /> Iva— (sg"az°'e) <br /> 'OC. �'or1 4 C <br /> Relinquished by (sw wur.wd a.v"dit Received by (sgn.e..and P,mwd N.m.) 7 —r,Date Time <br /> Relinquished by (sw.o,..snd w.,wd wm.) Received by rsgmt.. d P.,w Na.) Date Time <br /> Relinquished by (s pe o wed Prn.i.d"am.) Received by (sgnaa..and P+mi.d Nems) Date Time <br /> I hereby authorize ATL to perlorm the work indicated below Send Report To Special instrucbons/Comments <br /> Unless otherwise Pr3c, <br /> ct Mgr/Submitter Ann _ _ T re eH�J J� ��5�pu4� P 5:3 .1 ZoZ, <br /> requested,ail /J� 4k r <br /> samples will be �' -, Date �"" ?ter _7c. Co_.. _ -lJ�� .� Zen�, � eS QVC VW'Z <br /> disposed 60 days Prim N <br /> after receipt --- - lJ`lf� Address <br /> Sgnalure City State Zip <br /> (SUB IP TO CONTRACTT) SBAB IP TO CONTRACTi (SUB ICONTRATO CTTIB Circle or Add , �v <br /> Analys�,As} , CIRCLE APPROPRIATE Z Q A 1 Q C <br /> TEST TEST TEST Requested �y� oo a MATRIX O RWB <br /> ATL v ATL x ATL ��" a, 0 �G 0� U� p` t� J tiQ i— <br /> ED <br /> DATE DATE DATE F° RO ��" y� o� �o �� Q ¢ VAP ❑ <br /> CLIENT I D CLIENT JD CLIENT I D 0�m ��mg `° OVA� my t� v v ti y �� NAVY ❑ <br /> LAB USE ONLY � m" �� �� c,� Lu CT ❑ <br /> T Batch # Sample Description +:ryoP $: sorry^m �Qr ho +%, �„ P ?� �� Container(s) 0 OTHER <br /> E Lab No Sample I D Date Tlme ry�o ��o pati heti h� "� 0` ° �y ~� 2� c� � <br /> M p moo' �o 0o N 0o mo e m` �O O• �� QQ �� O TAT # Type cc REMARKS <br /> r V�� nr <br /> V w - 1 IOC~ i ri <br /> i <br /> i <br /> PCsI I i X 1 L <br /> VJ -z 4L <br /> i <br /> SampleArrnivia(Disposa Overnight Emerg ncy Crdical Urgent Routine 'TATstarts8am Preservatives <br /> ❑ Laboratory Siartaard TAT A= S 24 hr 8G Next workda l C= 2 Warkaays D= 3 Wtarkda s E. Workda $ tollowns day M sampies <br /> ❑ Omer received attar a an H=HCI N=HNO, S=�-1.50 CC4 C <br /> ❑ Flaturn To Container Types T=Tube V=VOA L=Liter P=Pint .=jar B.Tedlar G=Glass P-Piasttc M=Metal Z=Zn(AC)- O=NaOH T-Na�S03 <br /> *a 10 00 FEE PER HAZARDOUS SAMPLE DISPOSAL DiSTRIBUTION While with report Green to organic Yellow to inorganic Pink to Biology Cold to submitter <br />