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OO McCampbell Analytical, Inc. CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd./ Pittsburg, Ca.94565-1701 TURN AROUND TIME:RusxE3,1 za HR Orae HR pjrz HR i]s nnv ;lo DAY ❑ <br /> www.mccampbell.com / main@mccompbell.com <br /> GeoTmcker EDF[1I PDF❑; EDD❑j Write Gn(DW)❑; EQuIS <br /> Telephone: (877) 252-9262/Fax: (925) 252-9269 ❑ <br /> Effluent Sample Requiring"J"Hag❑, UST Clean Up Fund Project Qq Claim# <br /> Report To: iF _S._5,er Bill T . e;I Q S cJ <br /> Company: Anal sis Re uest <br /> 00✓! • }- '"cl h <br /> t­o <br /> 1 � . C szz or Y � n <br /> Vc a f % EE-Mail: psSQrS e J.ce-i '� 'w S _ 9 <br /> Tele: a J v 1I3 Fax: c? d — <br /> Project#: • ZV 1 'F. i Project Name: AJOA Dq'? I( <br /> Project Location: Lu d;, (A Purchase Order# '" ,e e - <br /> Sampler Si nature: Po o w e <br /> SAMPLING MATRIX METHOD w �, a` a G 0 h i r `? > <br /> PRESERVED <br /> U � r •� O 4 m c � n S <br /> SAMPLE ID Location/ w ,�, x o U z g q <br /> Meld Pour ° > ``' 3 a y g <br /> Name Date Time c 3 °_° "' p <br /> eLi L K ° = a' c v'i v vim, N N h _ V <br /> U " '= A - L � � v z t F � s '> F a a a a a a a E � <br /> ( - 3 IX x k <br /> iPs;'- r:io x x <br /> GIP .n _ I*r "J <br /> &1P x <br /> J r <br /> a o' 3:0' <br /> 6le x <br /> '' i7) <br /> - S <br /> "NI -1 clients MUST disclose any dangerous chemicals known to be present m their submitted samples in concentrations that may cause immediate harm or serious future health endangerment is a result of brief, <br /> gloved,open air,sample handling by MAI staff.Non-disclosure incurs an immediate$250 sm-charge and I e client is subjec <br /> us to work safely. full legal liability for harm snRered. Thank you fm your understanding and for allowing <br /> Relinquished By: Date: Time: Ree ' it ICur= <br /> �p "1Y GOOD CONDITION_ COMMENTS: <br /> HEAD SPACE ABSENT --sold -ru SJ 1;11 0 <br /> Relinquishe v:'/+ / tc: Tim : ei a By: ✓ / DECHLORINATED IN LAB _ `p', <br /> /� .r1 j APPROPRIATE CONTAINERS_ l'1 1( (0 '�PI �i' Af7 u{f5,n <br /> �✓ I / I PRESERVED IN LAB_ <br /> Relinquished By: Date: Tim : civcd By: / <br /> VOAS O&G METALS OTHER HAZARDOUS: <br /> PRESERVATION nHQ <br /> Page 24 of 25 <br />