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v LUNWHU, LA 9452U AIYU ANAL r,lJ rfr.WUr-*1 <br /> F H Y l R fJN M5 510 885-7852 <br /> tlr tAaoRAToeira 1800) 423-7143 ; ,;; ;.�' ,i; ). .I•�u 1 : . c �..,1.;,#:�, ' l;�,i. <br /> ompany Name: Phone#: <br /> ❑ p <br /> FAX Il: ❑ c m ❑ <br /> -)mpany A ress: Site location: WL)a* 0 <br /> ❑ ❑ 11 2 cc <br /> cei <br /> cc Y <br /> L ❑ o a ❑ <br /> oject nage : l,� Client Protect ID: (q)/i�-7 0��� ❑ m + + ❑ a ❑ <br /> w2j�4j �(t 1 NAM (,11+ <br /> V/�V v o 1 ,71A ❑ ❑ ❑ ❑ z In <br /> z ❑ ❑ <br /> ttest th the proper field sampling Sa pier Name(Prin)- ❑ o ❑ ❑ C ❑ ❑ <br /> xedures were used during the collection a �„ ❑ ❑ m a a a A <br /> these samples. ❑ Q S Q a R c a a D <br /> a r• <br /> e Matrix Method Sampling 2 �* `� a a < 8 0 o ❑ <br /> Field GTEL F Preserved ❑ _ ❑ o 0 0 a. ii ❑ o <br /> Sample Lab # W � N � :� �; N co x m J <br /> ID. (Lab use only) °o z d o W �, Q a bi o o O <br /> a -J ¢ ¢ H U z W I �a¢ '„ �a — fl a a a as a s a V a <br /> 3 w R ul a O 2 S 2 V p�❑ r cu m x x O 1- ill w W W ill W W W F- W <br /> 1 i X. <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> gorily(24 hr) ❑ GTEL Contact <br /> gpodited(48 hr) ❑ Quote/Contract N <br /> Business Days ❑ Confirmation N <br /> cher POO SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location: <br /> usiness Das ❑ <br /> QA/QC LEVEL <br /> LUE❑ CLP❑ DTHE FAX❑ Work Order# <br /> Reli Ished by Sampler: /Dale Time Received by: <br /> kI *E—,— NIM I <br /> v U STO DY Relin d y. Ddtb Time Received by: <br /> RECORD Relinquished by: D to Time Received by Labor tory: <br /> 7191 ' 'Waybill <br /> 7 y��, <br />