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KIFF O Davi 2nd Street, Suite 300 <br /> Davis , CA 95616 <br /> Analyt/Cal LLC Lab: 530.297.4800 SRG # I Lab No, <br /> Page 1 of L <br /> Fax: 530.297.4802 <br /> Project Contact ( Hardcopy or PDFTo): California EDF Report? Yes ❑ No Chain-of-Custody Record and Analysis Request <br /> Dan Schreiner <br /> Company / Address: Sampling Company Log Code: Analysis Request TAT <br /> 3017 Kilgore Road , Rancho Cordova , CA 95670 ❑ <br /> Phone Number: Global ID: 12 hr <br /> (916) 861 -0400 T0607700508 <br /> Fax Number: EDF Deliverable To (Email Address): ❑ <br /> (916) 861 -0430 dan .schreiner�stantec. com o <br /> 24 hr <br /> Project +: P. O. #: Sill to: a) <br /> 211602057 Stantec <br /> Project Name: Sampler Print Name: ❑ CU <br /> Stockton Charter Way Commingled Plume 0a y m 48hr <br /> o` <br /> Sampler tu � a U. <br /> co co <br /> Project Address: Sampiing Container Preservative Matrix w C ❑ <br /> 72hr <br /> 44A Ana FrIP tAl r` horfor VUow R a o m <br /> 1 0 w cN I a <br /> 1444 J Lincoin Ji W <br /> Stock'on , CA 95206 a0 <br /> > y N I II LLJ <br /> W x C 115 <br /> , <br /> E m > _ O c 1 1 _ Iw = <br /> Sample Desiqnation Date Time v cn ti 0 � _ _ = z Q m <br /> G1 <br /> 92033\/INF x x x x x <br /> 92033VEFF x x x x x 1 <br /> 24 hr d <br /> Relinquished b Date 7/ Time Received by: Remarks: <br /> iNulshed by Date Ts <br /> Relinquished by: Date Time Receive4 by Laboratory. For Lab Use Only: Sample Receipt <br /> Temp °C Initials Date Time Therrn. ID # Coaen[ Present <br /> [ �r Yes I No <br /> OistribuUon: White - Lab; Pink - 069iroto; <br /> Rev: 052011 <br />