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2795 2nd Street, Suite 300 17 <br /> Davis, CA 95616 ?� <br /> Lab: 530.297.4800 <br /> ANALYT/CAL LLC Fax: 530.297.4808 Lab No. , Page or <br /> P oject Contact(Hardcopy or PDF off: California EDF.Report? ❑ Yes ❑Ivo . <br /> C�' C? N S 0 Chain-of-Custody Record and Analysis Request <br /> ompany/Address: mended but not man toom etettussectim: <br /> Sampling Company Log Code:- <br /> Analysis q ~ <br /> ysis Re uest _ <br /> Phone No.: FAX No.: Global ID: <br /> /la S!—DI -W 01-77- - - - - - m X <br /> O C N ~ <br /> Pro'e{�Jc�tNumber: P.O. No: EDF Definat <br /> o( mail Address): S v CIJ EO ao <br /> �c C <br /> PCo <br /> rojec/�Nam/p�e: yy l Samplee: 2 o N in ao <br /> U -e PV l L�� ui n w m a o °e W V� <br /> O � m (� � � LO Q to b N <br /> ~ Z Z 'D to ❑ J C <br /> Project Address: — a- o- N <br /> n�A1Sampling Contain r Preservative Matrix m o N C" ; m L <br /> R��f71) <br /> (.14 n 1 m C7 y `o w m H a� u v M co <br /> Vrf, a VC 4�z.,�}} N O m .N 2 G1 p N 7 0 <br /> Q > VL m d ❑ ^L N C C C ca ca � m O 2 N L LL <br /> LLU LU LUit o Z H K ~ y N co rn m d) 0 fn v a <br /> E J g X N C7 T T X N <br /> Sample Desi nation nate lime a n _ U Z 7a7 ° a a_ a ox oX o o a t <br /> 7 (n rB m F F N �n n �n n J > <br /> 12 0 <br /> 02 <br /> Rel' quis ed �]Date <br /> Time Received by: Remarks; <br /> L'!WG <br /> Relinquish d by: Date Te Received by: <br /> ERefinquishe by: Date Time Received by Laboratory: Bill to: <br /> �-- rl <br /> Distribution: White-Lab, Yellow-Fite,Pink-Originator <br /> Forms/coc 121001.fh9 <br />