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General COC MAI Work Order# b� <br /> McCAMPBELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> O J 1534 Willow Pass Rd. Pittsburg,Ca,94565-1701 I um Around Tintc I Day Rush 12 Day Rwhj 3 Day Rush STD 0 Quote# <br /> Telephone:(877)252-9262/Fax:(925)252-9269 1.11ag;(\tt)l. IiSI- Cleanup Approved Dry Weight Bottle Order# <br /> r(�i <br /> www.mccampbell.com main mecampbell.com Dchvery format: PDP Georracker EDP IiDD Write On(DW) Dcteel Summar <br /> Report To:TAMARA WOODS Bill To: MACY HUMPHREY Analysis Requested <br /> Company:TERRACON CONSULTANTS INC <br /> Email:TAMARA.WOODS@TERRACON.COM Z) <br /> Alt Email: Tele: 209-712-7159 w <br /> Project Nalne:BUDDHIST TEMPLE Project#: NA177056 Z <br /> Project Location:11253 N.T RNTON ROAD,STOCKNPO tt fn IN <br /> Sampler Signature: w L1J <br /> SAMPLE ID Sampling = Q n <br /> Location!Field Point a Matrix m <br /> Date time s _Z I <br /> GW-1 5-9-2018 1 GW (� <br /> GW-2 5-9-2018 2 GW - <br /> TRIP BLANKS 2 <br /> NIAI clients NIUS7'disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause unnrediatc hamr or serious future health endangerment as a result of beef,gloved,open air,sample handling by MAI stall <br /> Non-disclosure incurs an immediate 5250 surcharge and the client is subiect to full legal liability for harm suffered Thank you for your understanding and for allowing us to work safely. <br /> •If metals are requested for water samples and the water type(Matrix)is not specified on the chain of custody.MAI will default to metals by E200.8. Comments/Instructions <br /> Please provide an adequate volume of sample.It•the volume is not sufficient for a MS/MSD a LCS/LCSD will be prepared in its place and noted in the report <br /> Relinquished By/Company Name Date Time Received By/Company Name Date Time <br /> r u— l7 d <br /> Matrix Code: DW=Drinking Water,GW=Ground Water, WW=Waste Water, SW=Seawater, S=Soil,SL=Sludge, A=Air,WP=Wipe,O=Other <br /> Preservative Code: 1=4°C 2=HCI 3=H_SO.t 4=HNO3 5=NaOH 6=ZnOAc/NaOH 7=None Temp °C Initials <br /> Page_of <br /> Paye 10 of I <br />