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<br /> WESTON Ar,,-- ics Use Only --
<br /> ustod Transfer RecordlLab Work Request 9 2 0 7 a 2 e 8 y q Page i of
<br /> Client £ Relrfgerator#
<br /> Est.Final P177,
<br /> rof:Sam Itng Date 4 a ? xi rt RSolidz�, 77,
<br /> YI� LI ttld.' * 3 ! ,
<br /> # Container
<br /> 7,777
<br /> Work Order#
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<br /> s �- -. � �'� '- Volume Lf W�` �` r',
<br /> Project ContactlPhone# 7 ' " ."Solid . ri
<br /> AD Project Manager d" t e'T. ° rL,M bray Preservativesc.,i
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<br /> Del- TO �: }
<br /> ANALYSES z`w `� � * " :•
<br /> Datd Recd Date Due REQUESTED a ¢ 00 �°
<br /> Account#
<br /> OC m a
<br /> MATRIX. Matrix WESTON Analytics Use Only
<br /> `•:, �
<br /> CODES: ',
<br /> Lab QC Date : Time LU
<br /> S Spji ClientlD/Descriptlon Chosen Matrix
<br /> ID Collected Collected
<br /> SE»Sediment , (✓) x ti
<br /> SO-Solid
<br /> SL-'Sludge :' MS MSD
<br /> W- Water r ^"�' r; �j: f %ts �.w. ;c, , �,. : •�•: ,•. a .�-:" . : _.. s. y
<br /> ?O= "O!I zrsi � � /L � -
<br /> A M Air �. + r r
<br /> DS Drum r ",�'�.`. t EY a. ,s:,--�� njf��p" ¢p'y.,? ,cP, per G :•..ss "-,,-"4
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<br /> FIELD PERSONNEL:COMPLETE ONLY SHADED AREAS 'DATE/REVISIONS:
<br /> Special Instructions: (� { 1. WESTON Analytics Use Only
<br /> 1 r ) 2 Samples were: COC Tape was:
<br /> "�`h e 5 a p l e 5 5 c p Y�i �P f 1)Shipped or 1)Present an Outer
<br /> f lI ! ` ! �� 3• arid Delivered Pac fge "Y far N
<br /> t )Pre 4",1, f 1 e A n Q e c( 7 0 4 "NSI '~y 2)Unbrdkin on Outer
<br /> I 2)Ambit Chills „packa
<br /> 9j
<br /> 5 -_. .( '`[�} se' Y Sample N
<br /> 3)Received,ln Good' present on Sample
<br /> CondcthcilyNzeJ for SofuA61v IFa(l a3� �� F � 4)La io� of N -9r N
<br /> 6• 4)Labols Indicate 4)Unbroki n
<br /> Relinquished Received Relinquished Received PropeMiffilfi
<br /> Sampler or N
<br /> Date Time Date Time Discrepancies Between :Ted;�
<br /> � -
<br /> by�. by? by by Samples Labels and 5}Re � COC R cord Present
<br /> r. -'� f r" COC Record? Y or N Upon SamY Rec't
<br /> y ; '' Holding Times') Y}or N
<br /> NOTES: - YJ o N
<br /> }
<br /> RFW 21-21-001lA-7/91 L372 L373 L375 L377 L378 Ref# Cooler# 381-596a
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