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J <br /> KIFF 2795 2nd Street Suite 300 � <br /> Davis,CA 95616 <br /> Analytical LEC Lab 530 297 4800 SRG#/Lab No <br /> Fax 530 297 48o2 Page 1 of 1 <br /> Protect Contact(Hardcopy or PDF To) California EDF Re ` <br /> R Smith P Yes "0 Chain-of-Custody Record and Analysls Request <br /> Company 1 Address Sampling Company Log Code Analysis Request TAT <br /> Horizon Envlronmentaf Inc HEIE tt <br /> Phone# <br /> Fax# i a <br /> Global ID m a ❑ <br /> 916)939-2170 916 939-21$72 I T060779162712 12 hr <br /> Protect# P 0 # EDF Detivembie To(Email Address) a c <br /> 707643 3424 Idl tak honzonenvironimental net w m - ❑ <br /> Protect Name Sampler Signature - Brandon Schlegel _ N a o 24 hr <br /> COa <br /> Quik Stop 76 ��� w m w g <br /> 1 a ¢ n m ❑ <br /> Protect Address Sam Im Container Preservative Matror ® m (N R w a m a o <br /> Stockton r m N la. z a >� o <br /> a 48hr <br /> m ro m n¢ n C' `c c a ❑ <br /> _> m m Lij m @ I; o o W o 72 hr <br /> p m !tl LLi C7 a A .9 W `� H <br /> Sample Deal nation Date Time in a° cry s i z° S�`a a g t0 W z ❑' <br /> 'c ^ > > > � 3 1 vNc <br /> MW-1 3 x I x x x x x x 01 <br /> i <br /> Relinquished by Brandon Schlegel tate Time Received by - <br /> Remarks Standard TAT <br /> �- Otof ft Lf <br /> Relinquished by Date Time Received by <br /> Ekil to Horizon Environmental Inc,Gary Barker <br /> Relinquished bEnvironmentalDate Time Received by Laboratory - <br /> ,�: For Lab Use Only' Sample Receipt <br /> l� y �'r�, Temp•C Inibalm DaW Tine Therm ID� Cacho a.,� <br /> DmMbOon Whita-Lab Pink Onginator N < <' d LO JO <br /> Rev 051805 <br /> I <br />