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General COC BRUSH MAI Work Order 1 1-0)v <br /> ® McCAMPBELL ANALYTICAL,INC. CHAIN OF CUSTODY RECORD <br /> O1534 Willow Pass Rd.Piusburg,Co.94565-1701 Tom Amtmd Time:I Day Rtshl X 12 My Ruohl 13MYRohlSTI)l I Quote# <br /> WO <br /> Telephone:(877)752-9262/Fmc(925)252-9269 J-Flag/MDL I ESL I ChnummAppreoxil I I Bottle Order 111i <br /> Www.Men phcllxom maintaamecumobell.cant I PDF I I G TmackerEDI'l I EDDI I Wmc On(DW) EQuIS <br /> Repon To: - [(,. Bill To: RAOsa Analysis Requested <br /> Company: 4f.6 "'JA <br /> Email: _ e <br /> W. - .RC6S2GLC. TLRtAU..s CL m � ;I 'o u <br /> Alt Email: Tele: g@g Y o e <br /> Praect Name: Pro'ect#; €� : < e S 9 <br /> j IaD: hst 1 �� E E y 3� <br /> Project Location:j S.FAa. G Al�E 'CfhPO# F_ _ - i 3_I C a 8 a = sit <br /> Sampler Signature: ? '- = $ e $ <br /> e <br /> It <br /> e <br /> SAMPLE ID Sampling a 5 9 I s 13 `e S <br /> Location/Field Point € Metrix Pmwmi.e IWJ a e v a 31 s e v S R D - a <br /> Dale Time �+ 6 r t„ <br /> C�n1 015A A VDA 14cl, <br /> - SG iii 1�7+� SA SmML a4 <br /> IoAl dime MUSTdidmeany daagcWs dcaiols l xa tree preach in lhdrrvbmiild rampleado mrcemairns that maycoo,imediae harm attended inumbrnnb weirgammi a.man ofbikf,gkmd pvemma.ma <br /> mpleldliagbsa1 <br /> y MAl L <br /> Na,dislmme imurs m immMidee S33p suwhuge and da chem is subiea to fWl legal liabiliry ranami mRcN.Tiwt>m fm>vmwJmmntlingand fm allpwing m to Hort sartlY <br /> •Vmemis arc mquestd for xatersamples otndthe xamnype(Mavix)is not speai0ed on the chain ofcunody,MAI will default to metals by E2oa.e. Comments/Wuuetiom <br /> Pkmp provide an adegmmeed....rnampk.Vthcvolume is aw'.1rece,for a Mii MSD a LCS CSD will be prepared in its place dead noted in the report <br /> Relinquished By/Company Name I Dom I Time I i:: Dy/Capwblmeaddc than Time <br /> 35A /zo <br /> Matrix Code:DW-Drinking Water,GW=Ground Water,WW-Wade Water,SW-Seawater,S=Soil,SL=Sludge,A=Air,WP-Wipe,0-Other <br /> Preservative Code:1=4aC 2=HCI 3eeH2SO4 4=HNO, 5eeNa0H 6=ZnOACNaOH 7-None Temp DC initials <br /> Page_of_ <br /> Page 10 of 11 <br />