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Y <br /> 4080 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD 32528 <br /> GTEL CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> (510) 685-7852 <br /> �.°e"i TEL <br /> (800) 423-7143 + 1 <br /> Company Name Phone# (SIO) 671- ).W <br /> I I <br /> FAX# (5-10) bSS~ 9J116 I I I I a l l <br /> Company Address Site Location � � 1&(J;rfi '61"'l m l i I c o <br /> x}057 P6rF Cht(pSb �k`y 5 ❑ I ! I I y cc <br /> CV 9 <br /> slo /170nkca CA �! � d � I <br /> emccr41 CA ❑ rn a I i �I <br /> Client Project ID # ± *- a �t a N <br /> Protect Manager 1 ( )O'r��p2,630 y y N N = a H <br /> ,� m o o fl Il II I z z II Oy <br /> I.attest that the proper field sampling Sampler Name(Print) p l l m _M c I 1 I I R E I l o <br /> e- b Q I I I I O J J D Iwo 7 <br /> u N I ! <br /> procedures were used during the o o y M a N l l 11 m a a g o n c <br /> collection of these samples Gr I�I In o a N 12 V a f I a y ! I a° <br /> t IaI 8 w y m 10 d w om a m m I I a O o u r. H <br /> Matrix Meth d Sampling o a 2 m I1 w -RC a m I I I I IN 'i a <br /> Field GTEL W Preserved m m � c I l t t w w a `� d y a <br /> m °° a r I t f 1 I I a a I I g m m i2 <br /> Sample Lab# a w X 2 d °i e z <br /> p F— It (h D it Y O cG L7 V y U Q .0 � c0 10 eD co 1D t0 Q <br /> 1D Lab Use z J i] ws O mw uJ F w w w o v0 u m a a a a a a a a <br /> y a O Q Cr F r, z rn w o e M „ a o a a a a a o a a v a a <br /> only 3 rn 4 v1 a 0 z i U � O. D F m m 6 I- w w w w w w w w w I— w V J O cg <br /> TV+ I A <br /> 01 11 )0 <br /> - <br /> OZ I <br /> O � <br /> 05 I �►� <br /> MW 41 11. <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> Pnonty(24 hr) ❑ GTEL Contact <br /> Expedited(48 hr) ❑ Quote/Contract# LVC 9y OCqS _ <br /> 7 Susi ess Days Confirmation# <br /> Other SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> Business Days ❑ PO # <br /> OVOC Level Work Order# C4 Z <br /> Blue❑ CLP❑ Other ClFAX❑ <br /> Relinquished by S I at Time Rec <br /> �9 — /&3#/-J le"Co <br /> CUSTODY Relinquished 6y Date Time ec ved by <br /> RECORD <br /> Relinquished by Dato Time Received by La r" <br /> �1- z q' �v7 Wa bin# <br /> 6�' !!- <br /> iftiPi rT @.J• -W I <br />