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l ® cLaren ! 4rSID.,FO,CHAIN OF CUSTODY RECORD 32566 5 6 6 COMPLETE <br /> INSTRUCTIONS <br /> f L r'��' ` ',f' ' r C/ Project Name: l !'r y'��✓ ter G�f FOR LABORATORY USE ONLY <br /> i Ship To: � �- f�',- et�t <br /> Address: > / - Project Number: " C 0l r. �� c Laboratory Project �� �( �J 411; orb <br /> t ���' <br /> Storage Refn erator ID «— ��_ 410.2 <br /> Project Location:(State) C� g g , `�- 416.1 <br /> Storage Freezer ID 44& <br /> 1 short Method <br /> I 5W <br /> Sampler Name S, PPE Worn to Field 503E <br /> / 1 '�._ i' C� ✓ f i <br /> 5242 <br /> Rel 7;slsed By „ f �' D;te/�yn Received By or Meth of ShipmentMapment I D Dateffune <br /> 02 <br /> W4 <br /> Re tushed B a �'/C> Date/Tune Received By,or Me of Shipment/Shipment I D DatefCv�ig <br /> 610 <br /> ✓f ! s 4 - f ��SV' 624 <br /> eLn4mstied By f Datefrime Re of � +rpment/Shtpmera I D DaWTune 8010 <br /> soiss Mad <br /> Sample Disposali 2 3 4 AN YSES REQUESTED at <br /> (check one) Level of ❑ ❑ ❑ <br /> (see Side 5 7 m <br /> Write , aoeo <br /> Laboratory Standard ❑ ❑ ❑ Analysis Method 6 <br /> ❑ Other SAMPLE INFORMATION ,831,i0 <br /> BTEX <br /> -4, Chloride <br /> FOR L480RAYORYVSE ONLY Sample ID TiDescription Contamer(s) Matrix Pres CCLP (No sd.2) <br /> l�blp Number Date me Locator Depth # Type Type Type TAT °Q color <br /> Conduclwky <br /> c- FFWhp rd <br /> 2 3 _ f , _ 2� � (3WWW Mme+al <br /> Flet Chrorrsum <br /> 3 '-7 (f r- e,T 'f�. X Ian Bakrice <br /> mMd 8 nieMwd ' <br /> g <br /> Me"PPP* <br /> _ f MNa4 We 22: <br /> TTLC L" <br /> STLC L" <br /> 7 L .�+ I r 5 / ; ' C✓ �_ <a i 1 X (ses Side 2) <br /> p <br /> Nitrate <br /> 8 f' ,' 1 S I /11//1- L oigR Asad <br /> 9 Ory Mercury <br /> Pero"Moisture <br /> 10 Percent Solid <br /> Perchlorate <br /> PH <br /> Special Instructions/Comments _ Container Types A=1 Ltter Amber TAT(Analytical Turn Around Time) Pho'phda <br /> B=Brass Tube C--Cassette 1=24 hours 2=48 hours Phosphorus <br /> Sulfate <br /> G--Glass Jar P=Polyethylene 3=1 week 4=2 weeks Sulfdes <br /> 0--Other V=Voa Vial 0=Other TCLP <br /> VOA <br /> Senuvoa <br /> FOR LABORATORY USE ONLY Sample Condition Upon Receipt. k U SEND DOCUMENTATION AND R�SULTS (Check e) Tris <br /> Metals de <br /> •�� � <br /> { � I ill t ( '' t , -- - ,( ProlectManager/Office ._ 6' . c't �^ TWeltiardrrose <br /> ❑ CTotal some. <br /> Client Name <br /> TPHlD <br /> Company <br /> f e- /�ri % P/� r�G Tss� <br /> / <br /> Turb+ddy <br /> Address --- �r� � ? r Specify Total or 0i"44ed <br /> Phone FAX <br />