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Pafe 3 ef— <br /> ::. Chain of Custody Record On-site 'Dime Temp.Project MIMe 1 Q03 Groundwater Sampling Event 00-site 'Ilrne Tet <br /> np <br /> I. IIP 131JIGEM CO PortUto: Atlantic RIchtietd Sky Cond,tlour, <br /> 3Z'I.a1}t}ratary Cmttt'sui lYtnilber: MalcoruIc lcal 1* e�tts <br /> Date:. t Requested Due)Date(mm/dd/yy) 413103 WMiMiS ecd Dyrect 011 <br /> Setxd To B <br /> PIOW Fudh No-, AROO Stat[on 2193 Cansultwit/Continctor SECDR <br /> Lair Natne SEQUOTAMALMOAL OEM F1atcq Addreas• 2908 hors amin Holt Dr Address 3017 Kilgore Rd.. Ste. 100 <br /> Lab Address 885 Jarvis Drive ID No. --- Rancho Coxdova, CA 06670 <br /> Morgan Hill,CA 95037 Iwt Bat-121 3 e-mRi11:131) charms@gccor cam <br /> fiomh aloha!ID 0:70607700002 Consultant/Contractor Project No•77sP meas os o327 <br /> Lab PM Ron Babel(Sabrarmento Offlee) o PNII Contact Paul Supple L'oitstiltant/CoyxttacLar Tcle/Fem 018,8810430 <br /> Tele/Fax 916.92.1.41800 dress. P.Q. Box 8249 Consultant/Conic R. B�enkosky <br /> Re port e&QC Levei, Mora a.CIL 9+1670 [uvalm to Coos �[itfCatttla o�rbPfOEAI (Circle <br /> UP/OFt13 Accotmt No.. /F= (925)299.8801 13PjG EM XVbTk IWJcabc No 28982 <br /> L.ab Bottle Or1er Ttio MaSrk 1'reser kALI.ca Rntu es ted Analya n <br /> Item Sample Point iat/Lomg <br /> No. Sample Doscriptlon Time ' boratory No '�. and Comments � <br /> 00 <br /> viol ;� a <br /> 1 MW-2 310 12% X I I 3 x x 8 004.44921 -121,3503363 <br /> 2 MW-3 x 3 x x 38 00416591 -121.3497862 <br /> 3 MW-4 1 12 x f i� 3 x x s8 00406261 -121 3499983 <br /> 4 MW-5 1[{03 x 3 x x 8 00436751 -121 Mr 41 <br /> 5 QGTB x ?•� 3 x x - _. <br /> S-tmplve, a Name 41I} sired BF Af laden tc ma ccepted sr/AfWitttogte • a <br /> Sawn lees Company. <br /> Shipment Date. _ 3'- <br /> Siit went Methad• _ Q ,. <br /> Shi ment'1�'ac No: a `? ! aro <br /> $ ecial Znatruotlons' <br /> lad Scats In Place Ye; _�Io_ _ Teln Lura Blank Yrs_ No Coater cmptturc aa Receipt {'1�t BlankYea Na <br /> f)�stxtb►aiion 4Vhi[e Gaily-Laboratory Iyalluw COM-SPlGN.M 1 pmx Copy-Lmputant Umvictor lip Coe Rer.i 2W2 <br /> 1 - <br />