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SAMPLERS:(5lpnaturel CryAiN OF CUSTODY RECORD <br /> SHIPPING INFORMATION J <br /> JQ <br /> orrTO: Shipper V,)l 0 d P� -}i�55t C►c.-fr s <br /> rc� <br /> CALIrt I—( rUlra_/W4 tY)WAL L.A I'J� Addrass.q °}j B�,t-15 :,F,fk 0 S•�,�� <br /> ENS Pit Date Shipped <br /> Shipment Service <br /> Airbill No. <br /> ATTENTION: g'r' tv �,�e:• Cooler No. <br /> i <br /> , <br /> Phone No. <br /> Relinquished by:(5ignatura) Received by: (signature) Date/Time <br /> iv <br /> Relinquished by:)Signature) Received by' (S,gnarure) Date/Time <br /> Relinquished by:(signature) Received by:rs,gnarurel DatelT,me <br /> Relinquished by:(Signature) <br /> Receive for laboratory by%(S+g rarer Dale/Time <br /> a <br /> Analyyslslaboratoryshouldcomplete,"samplecandltlonup nr celpt,sect Ion bolow,sign and return top copy toJ.H.KLEIN FELDER <br /> &ASSOCIATES,9795 Business Park Drive,Suite C,Sacram n ,CA 95627 <br /> Sample Site Date Analysis Sample Condition <br /> ; lumber Identification Sampled Requested upon Receipt ' <br /> L'. <br /> ,-rY-V 7PY A,7 P 115' <br /> ILI 7' -Ery u' <br /> PL RECU',''LD <br /> GOOD CONDMO <br /> r <br /> LAS INSTRUCTIONS: Laboratory reports should reference and be billed by site IO# and contain the following: <br /> (1) summary of analytical methodology and QA work (blanks, spikes, duplicates) <br /> (9) dates for (a) sampling, (b) lab receipt, (c) extraction, (d) injection/analysis <br /> etectionlimits for all constituents analyzed for and reporting of all constituents detected which were not <br /> pecifically designated �y _ <br /> (4 V <br /> Lab Courtesy Copy <br /> White - Sampler Canary - J. H. Kleinfelder S Associates Pink <br /> ItiKbll Farm h1-b[, <br />