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JRNIALYTICAL 720 Olive Drive,Suite D Lab:916.2J7.480(} <br /> tLC Davis.CA 95616 Fax:916.297.4808 Paga °f <br /> Project Manager: Phone No.: <br /> i'.c oto. , f Chain-of-Custody Record and Analysis Request <br /> CompnylAddress: ti y rjtJNl � Tae�LCeQ. FAX No.: For Lab <br /> - Analysis Request Use Only <br /> Project Number. P.O. No.: Project Name: 1IUE.T.(X) <br /> UC 1� Foll w v'L waw c. V qd`1 <br /> ' TOTAL(X) <br /> Project Location: Sampler Signature: 0 3 <br /> 0 <br /> _©7. /Lr. 61" <br /> Lu in m y p <br /> Container Method <br /> Sampling (Type/Amount) Preserved Matrixy g V m N z <br /> co <br /> � m � .. N U :° c•f � <br /> o y o a m c�V N <br /> cn cUi� o = p g ° o o a o o v a <br /> LU m l6 MO m m ao W T y <br /> Sample o J ? o U Z � n a a a. a a C<L<L N <br /> Designation Date Time > m ,�, = z _ z 3 m m ►- w w w w w cs v T <br /> i1 <br /> 10 llf I Xr i 2 <br /> Resin uis y: Date Time Received by: Remarks: of.,r-tam dp Y M TIj F' 1{(?� <br /> ,AMA <br /> Relinquished Date Time Received Email address: <br /> ❑,doc ❑.xts ❑.txt ❑other <br /> Relinquished by: Date Time Recented by Laboratory: Bill to: <br /> I <br /> Dfs&fbution: White-LaQ Yeftow-rilk Pink-Off"ior C0C.th5 <br /> i <br />