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4080 PIKE LANE, SUITE c AIN-OF-CUSTODY RECORD 71928 <br /> L <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST(510) 685 7852 <br /> 1GTEL <br /> (800)423 7143 <br /> Company Name Phonell (916) 377-11700 <br /> Fluor Daniel GTI FAX # (916) 372-3791 L] ❑ <br /> LJ v ❑ <br /> Company Address a ya rc Or. Site Location ( '(� G CZC� ;, rJ [J o t <br /> ►te. 1110 W. ;acrnrnplttn CA 95691 � � �j [1 t_1 � � � 0 <br /> • C ro'CI. C Or v <br /> In VJ U CL <br /> Project Manager Client Project ID (#) Stot 0 #ca A31 l J r� d N - w -e 0 [a T <br /> y N <br /> laff Aurhtorlonlo STlIL1070700a?'I (6614 W o a L3 a r-3 c' Z z ° ❑ a <br /> I attest that the proper held sampling Sampler Name(Punt) ❑ c_ v f I CI j_ to C) o rr t <br /> a N a ❑ �i [J o J J a m 5 v N [J <br /> procedUreS were used during the (9 v M s. N r7 p m a a N o 1,- � c <br /> collection of these sam les J 7 .ti , r _ o o a ❑ 0 N o o Cl a N ❑ o <br /> IJ N <br /> N $ p aN Method ' a aN° f J ❑ ' ° " <br /> Matrix Sampling 8 <br /> m L) o LN�N <br /> ❑Presefve a LJ <br /> W W J Jm 'a <br /> a a _ <br /> _J <br /> Field GTEL w Il r LJ LI IJm <br /> Sample Lab W U ry <br /> u <br /> F- OC �ry 7 � a W- ` ff A u1 ,p cn W O a <br /> ID 4(Lab Use o a Q o s s ° W a' =z F w w v ro i m a a a a a a a J a . �, o <br /> 1 Only v 3 Q a u� a 0 2 S S U �zw m O'^ O F- 11 <br /> M m T 2 O r- W W W W W W W W W F W U J 0 U <br /> x <br /> ItAW <br /> '\ <br /> JJA-- - Ir -- n I n <br /> Ili, l�oi X <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> nonty(24 hr) n GTEL Contact <br /> xpedited(48 hr) Ll QUole/ContraCt# <br /> Business Days C I Confirmation# <br /> "her SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> utiness Days r I P O # <br /> OA/DC Level <br /> 110 1 CLP f I Other' I __ _- _ _ .-- _ __— FAX❑ Work Order# <br /> Relinquished b Sa pier Date Ttme Re ived by <br /> CUSTODY C'".� -r -5 ' <br /> RECORD Relinquished by Date Time Received by <br /> Relinquished by Date Time Received by Laboratory <br /> Waybill# <br />