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M 01111111 M M r■r A M M AIS M ■r M ■ter M IM <br /> M <br /> -� McCampbell Analytical, Inc. CHAIN OF CUSTODY RECORD <br /> OO TURN AROUND TIME: RUSH I DAY 2 DAY 3 DAY 3 DAY <br /> 1534 Willow Pass Rd./Pittsburg, Ca.94565-1701 ❑ ❑ ❑ ❑ <br /> www.mccampbell.com/ main@meeampbell.com Geo-riff cker EDF❑ PDF❑ EDD❑ Write On(DW)❑ EQuIS ❑ 10 DAY❑ <br /> Telephone: (877)252-9262/Fax: (925) 252-9269 <br /> OElRuent Sample Requiring"J"Mg❑ UST Clean Op Fund Project[Ji;Claim# <br /> Report To: Pl¢/ Bill To: wrA �*a Analysis Request <br /> Company 0.14virkr5p., /f oto.-lea-tt <br /> 02 T„d4e5+AeX 1Ja Lodl <br /> — M <br /> Tele: '10 U-1-110 I E-Mail: - ut i ✓ 'FE/ .[g '" a O <br /> Project#: IU 66 3 Project Name: w : c ,'_-• = M T <br /> Project Lo cation: /o chase Order# IS <br /> Sampler Signature: nla„ c o � g � _ (J <br /> SAM ZING MATRIX METHOD z �% 2 <br /> PRESF.R\'EDLocation/ z <br /> SAMPLE ID is <br /> y g $ H <br /> Field Poin _ <br /> Name TDateTime 4 ,� r B v d• u cr <br /> ab v` <br /> b.0A 2 X <br /> —MAI clients MUST disclose any dangerous chemicals known to be present In their submitted samples In concentrations that may cause Immediate harm or serious future health endangerment as a result of brief,gloved,open air,sample <br /> handling by MAI staff.Non-disclosure Incurs an immediate$250 surcharge and the caent Is subject to full legal liability for harm suffered. Thank you for your understanding and for allowing us to work safety. <br /> •••UmvialsaverejAillstedforwater som les and the water tya is notumclasdie.the chain of custody.then MAI will default t at E200.11. <br /> Bell aishe Date: Time: R 'e B . ICE/t' COMMENTS: <br /> I <br /> qq GOODCONDITION_ <br /> I'lA-I ('r HEAD SPACE ABSENT <br /> ri' r By: Dale: Time: dived By: DECHLORINATED IN LAB_ <br /> APPROPRIAI'E CONTAINERS <br /> PRESERVED IN LAB_ <br /> _ elingnishrd By: Date: Time: Rrrrisc - VOAS O&G NIETALS OTHER HA7ARDOUS: <br /> PRESERVATION 1111<2 <br /> Page 9 of 10 <br />