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oil <br /> :(Explain T <br /> PART I: rFFIIELD SECTION <br /> Collecto LSM Date Sampled a JP Ma-r LA <br /> Time Hours <br /> Activity:/K Enforcement ❑ ASP O H.W.Property ❑ Super EJ Other D RCRA TP Code 1 <br /> Region: ❑ SCERS—SAC �9-NCS—SAC D NCS—FRESNO ❑ SCS—LA D NCCS—BERK <br /> LOCATION OF SAMPLING: -•EPA ID NO. <br /> r - <br /> Name— l )i Q�� ���5 <br /> Tel. No <br /> Address s Dk�c'Q n Si <br /> Number Street City ZIP <br /> HML No. Collector's Type Of <br /> (Lab Only) Sample No. Sample' FIELD INFORMATION <br /> Cg-t-VoaG4-o1 soil _sloe, <br /> - o� soti ` S�0ug1� <br /> 0 - oy- S�> > ��1 5-{-•a rrY.v�o�c,� �t�.L. �. S t d.e, t��s+- <br /> / <br /> o r1 ) oS-� Q�Ca;.UC�o,►�` <br /> Analysis Requested: VS, l/t Y As F I v0. p%aj% r c, i_ <br /> O S <br /> Chain of Custody: SC-t cS�Y� <br /> Signature Title --�T neluslve Dates <br /> 2 _ 3 a <br /> a e Itle Inclusive Dates <br /> 36 _ <br /> Signature Title Inclusive Dates <br /> 4 <br /> Signature Title Inclusive Dates <br /> 5^ Signature Title Inclusive Dates <br /> Special Remarks <br /> duplicate sample given to company,etc.) <br /> PART 11: LABORATORY SECTION <br /> Received By Com^^J�� Title `/ <br /> Date <br /> Sample Allocation: D HML ❑ SCBL O LBL ❑ Other Date <br /> Analysis Required c c,1 <br /> I � <br /> v ) <br /> Indicate whether sample is sludge,soil,etc. <br /> Orig.—Lab. Dup.—*File Trip.—In:pector <br /> DHS 8002 (1/86: <br />