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Page_ of ' <br /> rNOW& Chain of Custody Record On-site Time' Temp <br /> 1 " Project Name 2002 Groundwater Sam lin ,Event Off <br /> P 9 site Time Temp <br /> BP BU/GEM CUNT Q o: Sky Conditions <br /> BP Laboratory Cantract Number: eteorolo cal Events <br /> Date: y j�( Requested Due Date (mm/dd/yy) f9g tgjDY d s eed <br /> Direction <br /> ' lE <br /> Send To: 1P/GEM Fadll No' ARCO Station 595 Consultant/Contractor SECOR <br /> Lab Name SEQUOTAANALYTICAL 1P/GEM Facili Address 6100 N.1fWY 99, Stockton Address 3017 Kilgore Rd', Ste 100 <br /> Lab Address- 819 Striker Ave 'Ute ID No Rancho Cordova, CA 95670 <br /> Sacramento. CA 9 1 rtIte Lat/Lo I e-mail EDD charmsesecor.com Q <br /> California Global ID T0607700319 Consultan Contractor Project No 77 <br /> Lab PM. Ron Bobel 1P/GEM PM Contact. t Paul Snp le Consultant/Contractor Tele/Fay 916.861.0430 <br /> Tele/Fax: 916.921.960Q <br /> Consultant/Contractor PM R. Benkosky <br /> Report 8c QC Level a �! voice to Consultant/Contractor E [Circ] <br /> BP/GEM Account No de/F= 925.299.8891 PJGEM Work Release No 28$73 <br /> Lab Bottle OrderNo tru[ j; Preservatives AM Requested Analysis <br /> N <br /> X - <br /> ' No.em Sample Description Time aboratory No c �+ Sample Point Lat/Long - <br /> e � , 0 0 OD <br /> N f and a <br /> _" <br /> 2 W1 Q <br /> s w-2 1 x 6 �I x x x <br /> 4 rJ X 1 i. X X <br /> 5 <br /> 6 <br /> i' <br /> 7 <br /> 8 -- �I ° <br /> FT <br /> Sampler's Name .Lj, 'dt-#4 IJ Retia, By/A#iiliation to a cepted By/ tion ate e <br /> Sampler's Com �Ii �`� <br /> Shipment Date <br /> Shipment Method <br /> S meat Trac No r <br /> S cial Instructions.- <br /> jq!mtody Seals In Place Yes No Temerature Blank Yes ' No�Cooler Temperature on Receipt /'Tri Bla.nl I Yes No_ <br /> Distnbuo White Copy-Labaratory I Yellow Copy-BP/GEM 'I Pmk Copy- anYCmtractor I B11 coc r ' <br /> C i <br />