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RICr'AMALT I11.AL EQUIVA rvices LLC Chain Of Custody Record <br /> Equiva Project Manager to be invoiced. mW 2- 9 o 3 INCIDENT NUMBER(S&E ONLY) <br /> 720 Olive Drive,Suite D sczmaar:6 ri �sC q 1 Z I Y `j $ 5 1 Z S DATE 12— p dI <br /> Davis,CA 95618 C rAti SAP or CRMT NUMBER(TS/CRMT) <br /> (530)297-4800 (530)297-4803 tax 0t -4MAT H Ew— 77 <br /> PAGE �_ of j <br /> /1� rf�. 4/t✓f��d Ate, wlf/ C1= 7--5 { +VQ 1 4,, L,,J. ,CA Toga • V v 9 60 <br /> EDF DELIVERABLE 10 a NO 4 WIa4UL ANT PP=ECT NO <br /> Z��ADT( �r•-PAW ba) Cc+o� Za?-Y33-ta!>� Y3.13 YL <br /> 11 SAMPLER NARMS)I I LAS USE ONLY <br /> TELEPHONE t1f FAX dAAO- <br /> a i-,T <br /> 3 - LF! Z�7-T 3s-bbYg�c�( {-c•.,•, ca f �.ec.•�S <br /> TURNAROUND TIME(BUSINESS DAYS) <br /> P(1D DAYS ❑S DAYS ❑72 HOURS ❑48 HOURS ❑24 HOURS❑LESS THAN 24 HOURS REflUESTED ANALYSIS <br /> ❑ LA RWQCB REPORT FORMAT ❑UST AGENCY m <br /> WmS MTBE CONFIRMATION HIGHEST HIGHEST per BORING ALL 3 $ z FIELD NOTES <br /> SPECIAL INSTRUCTIONS OR NOTES TEMPERATURE ON RECEIPT 3 E a Container/Proservative <br /> 4 Q v I or PID Readings <br /> 7 , r or Laboratory Notes <br /> U. <br /> SAMPLING No OF _ 4 4 <br /> USE Field Sample Identification MATRIX CONT x $ * } } M M g <br /> oxLr DATE TIME m o <br /> U - 3- 5 l rao So 1 er <br /> T -3 -10•6' r r /00 so I <br /> — ' r I o 103 <br /> r - Z �zv�9 GY <br /> 10ti So I 05 <br /> %1 1OZ61S0 1C•6 <br /> -35-.57- 111161 so r <br /> G -3 - o15 1103 5L 1 �Y <br /> N <br /> QaAgI 1 <br /> W(SQ—) by{ i0n2%n) TWne Ei <br /> s1nGDWwd by isomm") FISM*W by ISVL&Un) „^ Date Tone <br /> RdAW"W by(SIPteWN) - Rwwm i e) . DAte Time 0 <br /> DISTRIBUTION Wtute wAt Mai repDrL Green to RN Y8110W and Pink b CWRL 1011&DD Revision <br />