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[ f Y [ t t t [ [ L [ [ [ [ [ { { <br /> 2785 2nd Srest,Suite 300 <br /> Davis,CA 95818 <br /> ANALYT/CAL ccc Lab. 530297.4800 33CJ <br /> Fax:530.297.4808 � L <br /> Project Contact(Hardcopy or PDF To): California EDF.Report? El Yes p Lab No.No papa of <br /> �a `�` <br /> ' k m to-A, f 4� Chain-of-Custody Record and Analysis Request <br /> —Com <br /> ompany/Address: 1 Rm=-wa Ikdrwt wfsw�iori <br /> Alf. .sampling Company ILop Cods: F. <br /> i�.K.A Analysts Request <br /> Phone .: FAX No.: Global ID: - <br /> PC 37Z Jy3y Q/4 372 90 65 - 074 p- C- 0-0. -q m m <br /> ProJect Number. P.O.No: EDF Dsllwrabls To(Ercall Address): <br /> Project Name: Sampler Signature: o S <br /> Project Address: <br /> Sampling Container Pros IMMX <br /> Co <br /> c3 0 m 4 io v LL <br /> E w O z w <br /> -Sample Designation oats Time a i i z 0 z 3 m A 0 9 $ N <br /> �vl►w 6/y/°3 c <br /> os <br /> rn w � 04 <br /> n�w - <br /> c7 <br /> .� dg <br /> Rellnctuis Date Tme Received by: Remarks: <br /> Relinquished by: Dale Time Received by: <br /> Relinquished by: Dals Time IReceived by Laboratory: BG to: <br /> DWfibutlon: Whke-Lab, YWbw-tile,Pink-Origlnetw <br /> Forr WCw 121001." <br />