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2nd Street, Suite 300 <br /> Davis,CA 95616 <br /> Fat:: 530.297.4800 <br /> ANALYTICAL Lcc .4808 G 1 l7 C f 9 <br /> Fax: 530.297.4808 Lab No. / <br /> Project Contact(Hardcopy or PDF to): Page of <br /> R.Smith EDF Report? ®yeg [D No to Chain-of-Custody Record and Analysis Request <br /> Company!Address: R.00nrrwndur 6vt rqt ngod�m 10 eomvl�a a�...crton: <br /> HORIZON Sampling <br /> Company <br /> Log Code: DEEB Analysis Request a <br /> Phone No.: FAX No.: Global ID: T0607700492 ~ <br /> 939-2170 939-2172 m XM— <br /> Project <br /> Project Number: P.O.No.: EDF Deliverable to(Email Address): Ui <br /> 3641 Stockton 36,41-� rsmlthClhorizonenvironmental.not m <br /> Y <br /> Project Name: Beacon Project Address: m W � V p` <br /> Stockton �, s �, 4 0 = in <br /> Sampler Signature(below) v o a a �' win <br /> � n F °° <br /> Container Pr6ServatlV@8 X — ; v N ASam lin om 3 <br /> ` <br /> O <br /> 0 W a = ° m m m m m m ° — d <br /> W m L Q m c c c cm > 2 N t U <br /> n W W w m m c� v <br /> E W 0 z H J X m m [7 4� UJ m <br /> le Desi nation Date Time a m x = v z 3 w a a s o 0 o m Q m <br /> r r Ln r, ,n ti w > J <br /> /M64-� <br /> J <br /> �` <br /> Il: <br /> 12, <br /> t•S�f <br /> 69, <br /> �Z , <br /> �Wt`20 <br /> T1 <br /> ReiinquishedDate Time Received by: <br /> . Remarks: <br /> '2410000 <br /> Relinqui Dale Time Received by:..........•�•.... ..... ... Temp blit i/ <br /> InWal <br /> Time Coolant pre"ne Y 1 N <br /> Relinquished by: Da[e_Lj Tim8R ed by La tory: . Bill to: <br /> Dist�butions• -�'s-Lab.Yellow-File.Pirtle-Originator -•` i\ `�"'' ` <br /> Forms/coc 121001.fh9 <br />