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T 4080 1>IKI; LANE. SUIT E C CHAIN-OF-CUSTODY RECORD 314 5 8 <br /> coNcor�r�, CA 94520 AND ANALYSIS REQUEST <br /> .a.� (510) 665-7652 <br /> ...r .:.o...�..,, (800) X123-7143 y. <br /> Co n Name: I'ito+1e H: .w —z s 11," •. <br /> u <br /> FAX H: t I I I m i l <br /> Co spany Address: Site Location: V+w (,% Fi m c = a r <br /> m 1.1 f I rr o <br /> 5 YQ V�l ll. r ,n 11 I I u <br /> 'Projecl Manager. Client Project ID:(11) 3 I l � N " a! 1 ! <br /> C 5 I I I ! y z <br /> NAM (. Q m o 0 1 1 N I ! I r z z <br /> I altcsl thal the pmlier field sampling Sampler Name (Prinl): a I„ - ri_ I I I I E o <br /> CJ <br /> procedures were used during Ihr. ' c '' �.,! y NI { I I ! a a rn o <br /> t- A <br /> culleclion of thew sarn,lcs. d o o N { ! a o o a o a d t I a "' i t a <br /> o v LL w r N m a m ! I Nm Nm I ! a O l u r' a <br /> Method i3 ! I , o <br /> Matrix Sampling N e e d 0 4 o e 8 b <br /> ,n m n (7 a ,� I ! ru n a o I I I I ; H I ! a N I ! W <br /> Field GTEL .G Preserved I I 1 1 m <br /> t H I I ., n m co 3 I I 1 1 I I rya a I ! ro m A N i� <br /> Sample Lab N K N ro o n as v; <br /> 1' ,U u O N N N to 4 i6 b X y d n V } <br /> Q Cr rc .O (� } O O O O N N <br /> lf3 rLab U5@� Z w p o ui Q" ww w� w w x i2 c a n v> ,a ee w w m w O a e m 0 <br /> ` O '" -' D o x O ,n w n R 2 u W W n n i0 a m a a 4 a a a a a ro b e <br /> Only u ? p a ., (r +- i3 z ,,,, ., a a- r- > a. a a a a a a a a a a u a a m o <br /> ; ,n n. O z z T �? O"" o I m m 1 T O I- ,al u, w W w W w w w r- w 0 4 d u <br /> -- _ _ -- 01 <br /> - - -- -- --- - - - - - -- - - - -- - -- -- - <br /> �� . -- 0Z.-- - 3 - - - - -- - -- - - - - - - - - - <br /> __ - <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS: <br /> r.....n,y 114 hr, {i l rl Contacl --.--•-_- <br /> f •Is••rl„tat I.1il,rl � = OrrO,errnn,racl � <br /> Cnnhnnalrnn 8 <br /> n....., i'O SPECIAL REPORTING REOLIIREMENTS Lab Use Only Lot if: Storage Location <br /> OAlQC Level /y� <br /> [, .. ,.s r ct++.• ❑ Work Order N: C�07W <br /> I <br /> Is„hen 6 5- <br /> n yS;unrrl D, Tirne Received by: <br /> I—A/Z - � �� � <br /> CUSTODY <br /> tI,luxtu,l sed Time Received by: <br /> RECORD 1-5u s01). V) <br /> tirin„pnr:haal hy: .de Time Received by Laboratory: <br /> Waybill If <br />