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4r <br /> SIDE 2 FOR <br /> IM, qgnn CHAIN OF CUSTODY RECORD COMPLETE <br /> 3 c L INSTRUCTIONS <br /> / J V commm <br /> Ship To:1" ,' / _ Project Name: / E FOR LABORATORY USE ONLY Analytictl <br /> • 7 ( " l [f/ 0,2 a l Sf fJ 4;CG ! i Methods <br /> Address: { . r? '-� �' r, Project Number: {� Laboratory Project# �t' 4; i <br /> f Storage Refrigerator ID LI-IJ 418..1 shat M.ri,ed <br /> Project Location: (State) ! re 0 dr Storage Freezer ID 42MI <br /> 502.2 <br /> s0X <br /> Sampler Name , Spature f 1' PPE Worn in Field 5242 <br />� r / f � / 8(Ii0>Z1/ L <br /> Relinquished Bye <br /> Date/rime Received By or Method of 5htpmrnt/Shtpmera LD ' Date/l"une�� / � <br /> Rehnkmshed By Date/Tune RibWveFd By or Method of Shipmeut/Shtpmem LD Date rime 810 <br /> 824 <br /> 825 <br /> Rel <br /> + / <br /> tn utshed B Datefr—r- Pe v!O By or Method of Shipment/Shtptnent I D DatefT c 86'0'16' <br /> 0 <br /> 9 BY , f <br /> 8015 Mod <br /> I - <br /> Sample Disposal �y 1 ❑ 2 ❑ 3 ❑ 4 ANALYSES REQUESTED sit <br /> Level of <br /> (check one) QC am <br /> rite in WW <br /> (see Side 2) ❑ 5 ❑ 6 ❑ 7 Analysts Method k _ alto <br /> © Laboratory Standard <br /> 8270 <br /> [] Other SAMPLE INFORMATION Wieldy <br /> Description Container(s) \ CCLPP(see We 2) <br /> FOR LABOAMRYUSE ONLY Sample ID Matnx Pres coo <br /> ubm Number Date Time Locator Depth # Type Type Type TAT color <br /> Condudwity <br /> 1 r a r z ? 6 l -'-f r`C <1 1 ,/ l l Irl T c. FCta�s*Wd <br /> Fluor& <br /> 2 ! 1 r r r ! /f r I General Mineral <br /> Hex.Chromium <br /> ion Balance <br /> 4 r I ') S i 7 rz '1 L r - Z CI !T' MetabB010' al• <br /> Metals PP'(5 etie <br /> 22, <br /> 6 <br /> TrtC Level <br /> STLC Level <br /> j r 5 l ! r I f r 3 ' Ndrds Side 2) <br /> $ t ! <• ' F f / !�) 1! Oryx Lead <br /> 9 ; ;: r- ,/!— Gf 4Q 1 ^ Pe ow Mature <br /> 10 r - ~ / r ' Z/ 0Percent Solid <br /> Perchlorate <br /> Special - PH <br /> S <br /> l� � ' � F- Container Types A=1 Liter Amber TAT(Analytical Turn Around Time) PhO7Phatee <br /> I rT l !� r, 1; s i B=Brass Tube C--Cassette I=24 hours 2=48 hours Phosphorus <br /> i <br /> G--Glass Jar P=Polyethylene 3=1 week 4=2 weeks Sulhdes <br /> t_ r 0--Other V=Voa Vial 0=Other TCLP <br /> VOA <br /> MetSemrvoa <br /> FOR LABORATORY USE ONLY Sample Condition Upon Receipt. / '' SEND DOCUMENTATION AND RESULTS TO(Check one) Peurde <br /> r ,- i ProJectManager/Office � 1 r - } l� 0Y% J7daalHardness <br /> Toral Sohds <br /> ❑ Client Name TPWD <br /> TPHJG <br /> TSS <br /> Company Turbrddy <br /> Address Specify Total or Dissolved <br /> Phone FAX <br />