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4080 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD <br /> PGTEL CO0) 6857 52 94524 qND ANALYSIS REQUEST35�, 80 <br /> (51D) Gas 7852.o•.o.„ (800) 423 7143 <br /> ' I I <br /> Company Name Phone# <br /> (916) 372-4700 712 F n FAX # - <br /> Company Addres91101 19a1 ar d Dr Sfle Location m <br /> y _ a 5"G'-ter► l t+•n f�c� ❑ <br /> -tr. 140, 1." Sacr 7mrnto, CA 95691 l rrQ CA"r- �; © ❑ ❑ mcc <br /> 0 111 N V [L ❑ t� <br /> Project Manager Client Project 10 (# 0 ± ± g p a <br /> �.n Store # a� ❑ p d to rn a <br /> 1-3 It A,Fr-btorlani� NAM c m ri o ❑_ © ❑ ❑ z z 1 U © rt <br /> I attest Iii-al the proper held Sampling Sampler Name rinf 2 N �'+ oa o Wec <br /> U N [7 <br /> procedures were used dunng the 1 /� ( 1 r H b g a , ry a a N <br /> collection of these samples (/[! LJ' 1�` p c� © voi D N Uo coUo V p ^ U a N CI o <br /> © LL m T N Q v nCM Cq ❑ 4 0 c ❑ d <br /> MethodW co <br /> ,n Matrix Sarr litlg a to o na Q a 0 ❑ ' C ❑ LF <br /> rr Preserved a ❑ w d a o co �] a <br /> Field GTEL w _ . L7 w w m a. a m ro N H ❑ m U <br /> z F- © N n m o t� n F) El a 0. ❑ m `—" N m <br /> sample Lab # a N <br /> p w U o ,� ❑ N m 3 ul o X m s <br /> [Y (L c6 C9 T O O O N N L <br /> I d {Lab Use 0 o o w r w° uwi w x �? o c ¢ n n m �o .n m m O 4 v Q <br /> 1 only U O ¢ 1 a0� i v z Q z w rz-y I i. - - a 0 R d d d d a d R u n4. a m P o <br /> in a cn a O z z x _ �� ov ❑ f t m m x z O F w w w w w w w w w H w U -J O V <br /> Nt <br /> --Mu�('0 - <br /> --- - - - <br /> N1 z`0 <br /> —k4LD-JL- + <br /> I 3Z� <br /> 11 tA— <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> priouiy(2.11 ht) GTEL Conlacl <br /> Expndfiird(4 t3 hr) QuotelContracl H <br /> 7 13ugwe95 Drys Confirmalr6n H <br /> Business Days I I PO it SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> QA/QC Level <br /> ©hie GLP 01her I _ __— _ FAX❑ f Work Order# <br /> fleirn i ish by Si pier ate Time Received by —� <br /> CUSTODY r <br /> RECORD Rehn ryshe 15yrV <br /> al Time Rececvedby <br /> t 2.�i�, A� <br /> nol,ngiiished by Daie Time Received by Laboratory <br /> Wa bill# ti C <br /> t <br /> i <br />