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• • i <br /> r , <br /> 2795 2nd Street, Suite 300 <br /> Davis, CA 95616 <br /> Lab: 530.297.4800 <br /> ANALYTICAL c.cc Fax: 530.297.4808 Lab No.-30 2- Page--L-of <br /> Project Contact(Hardcopy or PDF To): California EDF Report? Y<Yes I I No <br /> Chain-of-Custody Record and Analysis Request <br /> Company/Address: ftecornmendedNAnot manti ywcom I�ebDdissBcton: <br /> c Sampling Company Log Code: i{ - Analysis Request <br /> Q <br /> Phone No.: FAX No.: Global ID: m X <br /> 0 <br /> N%Q Ofyl- ZY?p (�1tG j r 3� -Z+1 L '; 7 ) . J- I o 0cli 0 � w <br /> CN <br /> Project Number: P.O. No: EDF Deliverable To(Email Address): m °0 m C) >. <br /> iZ�l� -LI m C3 W ~ N N X o <br /> Project Name: Sampler Si nature: m "' m m m a o H <br /> w �n m w m In °ts w <br /> Project Address: in N <br /> Sampling Container Preservative Matrix h o m i <br /> m (7 N0 ♦- _� N N V i <br /> ` QLL <br /> y +-. {6 G <br /> -T'i 70 <br /> w r7 Lit J ro {`) 03 CD T pryp D t N <br /> Sample Designation Date Time a m m o v zz O � 0- a a o 0 0 0 a s N <br /> W 4] F I.- i-- in n V) r J w J <br /> X1 I X DC n r <br /> )A WZ <br /> W2!> jL S -,� - - 63 <br /> IIr1 Su y 6ce- <br /> ILI 1C L1 <br /> — - — - --- <br /> Relinquished by, Dai Time Received by: Remarks: <br /> 07 <br /> Relinquished b� Date Time Received by: VJ111 <br /> Relinquished by: Date Time Received by LaboratoryBill to: <br /> Distribution: White-Lab, Yellow-File,Pink-Originator Formslcoc 121001.1h9 <br />