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SSTL <br /> TL San Francisco jc-�- <br /> 12200uarryLane �f18i11 of Custody f�ecord <br /> � r <br /> Pleasanton, CA 94566 0 <br /> Phone(925)484-1919 Fax(925)484-1096 C) <br /> Sampler Lab PM: Carrier Tracking No(s)- COC No: CV <br /> Client Information (Sub Contract Lab) Brewer,Melissa 720-2256.1 � <br /> w <br /> client Cont2ct. Phone' r--Mall Page. CV <br /> ShippingiReceiving Imbreweri4sil-inc.rom Page 1 of 1 <br /> t` <br /> sTL Job a C3 <br /> Company Analysis Requested 720-9969-1 <br /> Address. Due Date Requested: 4 Preservation Codes: <br /> 7/23/2007 A HCL M-hlexane <br /> City: _ TAT Requested(days): B-NaOH N-None <br /> J / C-Zn Acetate O-AsNa02 <br /> D-Nitric Acid P-Na204S <br /> Stale.Zip E-NaHSO4 0-Na2SO3 <br /> •S,T'Y f 't ?C,-:'' F-McOti R-Na2S2SO3 <br /> Phone: PO B - G-Amchlor S-H2SO4 <br /> L-,:z Z 0. 11-Ascorbic Acid T-TSP Dodecahydrate <br /> C. Zt0 - I-Ice U-Acetone <br /> Email: l:�^ 'G' �� WO a' '� a J-01 Water V-MCAA <br /> C._ _ rp <br /> Project x: m K-EDTA W-ph a-b <br /> Project Name: I L-EDA Z-other(specify) <br /> Lammers Road Property 72002869CL <br /> a <br /> Site: SSOWk: w $- Other: <br /> U <br /> a <br /> Sample Matrix <br /> T e (w-veer, o y <br /> 00 <br /> Sample (C—Comp, C.."Oroq m <br /> Sample Identification Client ID Lab ID Sample Date Time G=arabli sTTh—A.A. LL t(h FSpeeml Instructions/Note: -1 <br /> ,.� <br /> --=77179 .;rrc�C[VatlOn Code:A, r $ - '. ,�k 44 <br /> o <br /> WELL-11 (720 9969-1) 7/18/07 7:50 Water JE <br /> NEW <br /> b <br /> a <br /> Possible Hazard Identification Sample Disposal(A fee may be assessed it samples are retained longer than 1 month) <br /> =Non-Hazard 0 Flammable =Skin Irritant 0 Poison B Unknown Radiological Return To Client Disposal By Lab Archive For _Months <br /> Deliverable Requested:I,II,III.IV,Other(specify) Special Instructions/OC Requirements: <br /> Empty Kit Relinquist)ed by Date: Time: Method of Shipment: <br /> Relinouished by: Date e: / Go ny 1 Receivepy' - DateMme: Company <br /> � Date/Ti ._ Company <br /> Relinoulshad by Da,Mrs .� Company Received by: l 1 <br /> Relinquished by, ` DaleMme: Company Received by: Dale,Time: Company <br /> Custody Seals Intact: Custody Seal No.: Cooler Tomperature(s)°C and Other Remarks: <br /> A Yes o No <br />