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Pacific Gas 62-1174(Rev 2199) <br /> 1,"L andElectric 107 Environmental Affairs <br /> Company <br /> Chain of Custody Record -7 <br /> From: Pacific Gas&Electric Company 0 PG&E Facility 0 Sample Site Ship To: Lab Name:Castic Analytical <br /> Address or Location: 17110 Carrolton Road Address: 2333 Shuttle Dr <br /> City: Escalon (Zip) 95320 City:Atwater -,CA (Lipj 95345 <br /> Contact Name/Phone No.: Warne Pacheco Phone No. <br /> Contact Name: <br /> Turnaround Time Analysis Requested <br /> El NORMAL(t4 days or less) Z RUSH Specify <br /> El TELEPHONE M FAX Give Results to:Wayne Pacheco{wtol r�iyt¢e.com} <br /> Project Name:Carrolton Spill Project Supervisor(Name/Phone No,): <br /> Sampled by: (Signature) (Print Name)Wayne Pacheco <br /> U <br /> Sample No.l Sampled Containers /R can arks <br /> Equipment Serial No. Date 'rime SampleType/Description No. Size <br /> 1 071911-1 7/19/11 Soil I Jar x <br /> ............ ............. ................... <br /> 2 071911-2 7/19/11 Soil I Jar x <br /> i- 7 <br /> *6'­l­�1 <br /> '­ 3 7-/-1-9 <br /> *** X- ......... ........................... .......... <br /> *** ' '­' .............. '­ ­*­'*­** ........ <br /> 4.471911-4 7ii4/Ii §0ilJarX <br /> ........ ----------- ................ <br /> 5.471911-5 7/19/11 Soil 1 Jar x <br /> 7114/11 S­*0­iI` <br /> -1- <br /> 1 7 <br /> 7- ­­­**­'­*.......... 7/**'­*1'9'*,11,1**** <br /> 09 I Sail 1........... ,'[*'*a*'r8.471911-8 7119/11 '*"*'*'**'*"**", <br /> 'S­0­iI­* "Jar ............. <br /> ............. <br /> 9.471911-9 7/19/11 Soil 1 Jar x <br /> 1,0* 7-71 9'1*"1-,1* S**0­ii .... .... .............. ........... .......... <br /> ............. .......... .......... ...... <br /> 11071911-11 7/19/11 Soil 1 Jar <br /> ........... ...... ............... ........... <br /> 12.471911-12 7/19/11 Soil 1 Jar <br /> 1-........................ ..................... ................... .......... <br /> 13. 471911-13 7,71-9/11 Soil 1 Jar <br /> l . ............ ................. ............. ........... <br /> ai <br /> R Iin uished by t ame Dept.)-., Date&,Ti Received by(Name&Dcpt� Date&Tinic- Ship Via: <br /> if <br /> pt.): Dao` �imc: Received by(Name&Dept.}: <br /> Date&Time: Bill(R—Lading/Airbill No.: <br /> Relinquished by(Name&Dept,): Date&Time: Received by(Name&Dept.): Date&Time: <br /> SAP Accounting Data: Billing Contact: Billing Address: <br /> — —--—------ ------ ----------- <br />