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Chain-of-Custody Record and Analytic Instructions Page _l of 1 B 00322 <br /> Send all results ces to: <br /> Field Log Book#(COC#) 3 Release# <br /> Wim, 0, aA-cO <br /> and circle} ORRD LL Sampling west# <br /> Attn: ORAD Data Management Team L-633 Analytical Laboratory Name T�L <br /> Lawrence Livermore National Laboratory tical Laboratory Log# <br /> P.O. Box 808, Livermore,CA 94550 <br /> ,"'N Ww :'�nr m," i.', <br /> Analysis & Turnaround Additional Instructions to Lab <br /> Also Fax copies to: Fax# Required 1 <br /> Project Name: TU P <br /> Sampled By : P, K k.c Sampler's Employer: Li-Nyreal�/� (:Ir�: <br /> 1 <br /> 1J <br /> Sample Sample Matrix/type 2 #of <br /> Identification Dale/Time Container/7'ype 3 Cont. Remarks <br /> T u to- ' j-01-1�IU1- S0 --17,D <br /> CNI Zo3.�9 <br /> Signature Company Time Date L N =normal turnaround, F= 1-week turnaround <br /> Relinquished by Z Lr./L !� dtj R=24-hour turnaround, 11=Hold do not analyze unless requested <br /> F <br /> Received byV)A41 f 3. /� 2 t 2. Sample Matrix Codes. See list on back of pink copy <br /> Relinquished by �QQjl� �,�'��� ,0 Z 3. Container type codes: V=VOA Bottle,P=Plastic Bottle, <br /> � <br /> G=Glass Bottle,T==Brass Tube, <br /> Received by <br /> G O .100 1 a �( B=Bag,S=Stainless Steel Tube, <br /> Relinquished by .30 / i+' O=Other(specify wider remarks) <br /> Infernal Use Only <br /> Received by U CC: <br /> White:Laboratory return to ORAD Pink:Sampler leaves with ORAD <br /> Revision 3.3 P i <br /> a(ki )i C)RAI) Attn.Data Mana ement Team 1•-fi33 Yellow:Analytical Lab <br /> 21i K „ ,Attn.OKAO Uu•:. ..magemenl Team L-633 <br />