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EQUIVA Swwices LLC Chain Of Custody Record Z <br /> Lab IdenhftWiemsY) IEqulva Project Manager to 6e Invoiced hICdI�19NI'WM$ta{5&C9AIM - <br /> Address �!40CNCE k Karen Petryna 9 8 8 9 6 1 8 1 1 DATE <br /> Oy State Zip T NIC�tLSERVI( SoptCitllif�"�iE MER(TSI0FthiT1 <br /> PAGE of <br /> ❑ I CIZMT HOMON 1 - - <br /> ANG COMPAW LOO WOE SITF AGDRE39(Slant and C" OL08AL rG NO <br /> Blaine Tech Services BTSR 2494 Fremont Street Stockton T0607700736 <br /> ADDRESS FDF DELPJERAMrE TO Imo+ P"a 0*09m T PHONE No E-KM CION3M ANT PROJECT MO <br /> 1680 Rogers Avenue,San Jose,CA 95112`V-1 <br /> PROJECT OONTACTINaampryPEW RWWlay Joe Neely 1707-933-2361 sonomaodf cambria•eTnv com 03 it <br /> Leon Gearhart SMOUAK WO)iPf"t i A61t18E4WWy <br /> TELEPHONE PAK E4AW- <br /> 408-573-0555 408.573 T771 geaThart blainetech com Keow F-/el <br /> NAROUND TIME(BUSINESS DAYS) <br /> 10 GAYS ❑ 5 DAYS❑ 72 HOURS❑ 48 HOURS ❑ 24HOME] LESSTHM 24 HOURS REQUESTED ANALYSIS <br /> ❑ LA RWQCB REPORT FORMAT ❑ UST AGENCY E <br /> GC/MS MTBE CONFIRMATION HIGHEST HIGHEST per BORING ALL 'Y z FIELD NOES <br /> O e <br /> SPECIAL INSTRUCTIONS OR NOTES TEMPERATURE ON RECEIPT G• so " Is COntainer/Preservativl <br /> m or PID Readings <br /> or Laboratory Notes <br /> +++ <br /> � <br /> in m w o <br /> .N.. 1l <br /> uS9 Field Sample Identification SAMPLING MATRIX NO F d r cc r c x M <br /> ONLY DATE TIME F m � 5 O w 2 w <br /> I <br /> s_ ! lid W tC X —0 <br /> f Q!td —02- <br /> o x 3r 4-03 <br /> S- l )oA-i k X x -d <br /> I <br /> 0 <br /> Relkgwshed by(S9nah9e) Recelwd by(Sgrarae) Qate Time a <br /> h_ <br /> Renewed by(501W%Ta) Oates rme s� <br /> by ) fi <br /> � I <br /> Recavad W(SW aL-) Date- rime Oa <br /> Reunotacned by i5gnanre) ��� /7 Lf <br /> DISTRIEUTION Whta with Mal report.Groan b Fie.YO w and Pmk 10 Cher¢. 16r1fi100 Ravaian <br />