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r • i <br /> 2795 2nd Street, Suite 300 <br /> /FF Davis,CA 95616 <br /> Lab: 530.297.4800 <br /> ANALYTICAL ec.0 Fax: 530.297.4808 Lab No,z7t/37,57 Page—Z of <br /> Project Contact(Hardcopy or PDF To): CalifOfnla EDF.Report? ❑ Yes KNo —4 J <br /> i <br /> Chain-of-Custody stod Record and Analysis Request <br /> omanyldess: fCW=Onded but not mndato w tts sectloix <br /> Gt/i� l3�G r• �� �h Sampll Company Log Code: t- <br /> r� ,� �1)2 Analysis Request <br /> Phone No.: FAX No., Global ID: in n <br /> Sia �G av 4�Gz02-Z� fl o N <br /> Project Number. P.O.No: EDF Dellver a To(Emati Ad _ x� xxo co In o <br /> n W W w N x C <br /> Project Name: `" N EQ JP N ¢ o <br /> 1 Sampler Signature: � � m y <br /> W m c7 C@i m n a ~ <br /> Project Address: � ~ Q a N ° a _J a N <br /> ��7G C�.7k CSS Sampling Contai Preservative Matrix �H o ti y N � 12 <br /> Q m V N N N N Vl N v 2 <br /> a12�- <br /> j m °' LL <br /> q Nil <br /> J U Z O Q uJ <br /> w LUM (7 rn rn rn m C N <br /> Sample Designation Date Time a (0 z x z F a aa.. a o 0 o fl Q. o m r <br /> cn m m r w F r. t" m y <br /> •- S �4� Gay � _ � a 4 <br /> Relinquished by: Date Time Received by: Remarks: <br /> Relinquished to Time Received by: <br /> Relinquished by: Date Time Received by Laboratory: Bill 10: <br /> Distribution: While-Lab, Pink•Originator Formstcoc 121001.th9 <br />