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i I <br /> J <br /> W <br /> General COC MAI Work Order# c o = Z <br /> JUJ <br /> s McCA11/IPSELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD �' F- <br /> 1534 <br /> 1534 Willow Pass Rd.Pittsburg,Ca.94565-1701 Tum Around Time:l Day hush 2 Day Rush 3 Day Rush STD Quote M LLJ Z Cc <br /> Telephone:(877)252-9262/Fax:(925)252-9269 7-Flag/MD4 I ESL I Cleanup Approved Bottle Order <br /> www.i-necampbell.com maig@mccaml)bell.com Delivery Format: 4eoTraclaa EDFI PDFj IEDD Write On(DW)l I O Uj <br /> Report To: Bill To: Analysis Requested tY <br /> Company: tick fi>il! Jr'.o B R /'h 1= �G) ;NG F > <br /> a. _ 7 <br /> err app L <br /> Email: rick 5 i Ot1G dN.d J -4 •e 0— y _ 3 is o� � � .. � 9 W <br /> r <br /> Alt Email: Tele: Z - 7-1172- E E a a Se o <br /> O O V 4 Y L O S N <br /> Project Name/#: 21744 Y-i v& Sficsi a, o > G� a <br /> Project Location: i-liilL7aN PO# + + v " e o e a <br /> v e r e F tq S <br /> e e � " <br /> Sampler Signature: .W CA-Vow r>cr6'e^ � o p � a <br /> Sampling G�aSAMPLE ID <br /> E <br /> !Location/Field Point Date Timmatrix <br /> Peervav <br /> /00_rj4 <br /> Arl <br /> - Solt.- � Too 5 <br /> Z dl/Gr5'r -- S o l L 7`W`t l <br /> 60V JtIG�ate, <br /> MAI clients MUST disclose any dangerous chemicals(mown to be present in their submitted samples in concentrations that may cause immediate harm or serious flu=health endangerment as a result of brief gloved,open air,sample handling by MAI staff <br /> Non-disclosure incurs an immediate 5250 surcharge and the client is subject to full legal liability for harm suffered.Thank you for your understanding and for allowing us to work safely. <br /> If metals are requested for water samples and the water type(Matrix)is not specified on the chain of custody,MAI will default to metals by E200.8. Comments/Instructions <br /> prepared• P report. iL 3 f5 Qli;Mt. '- <br /> Please provide an adequate volume of sample.If the volume is not sufficient for a MS/MSD a LCSlLCSD will be to in its lace and noted in the � <br /> Relinquished By/Company Name Date Time Received By/Company Mame Date Time 0)66t-7 '131+�Srtnc, wf4S i <br /> Matrix Code:DW=Driniting Water,GW�iround Water,WW=Waste Water;SW--Seawater,S--Soil,Sl;--Sludge,A=Air,WP=Wipe,Other <br /> Preservative Code:1=4°C 2=HCI 3=1­12SO4 4=HNO3 5 NaOH 6=ZrLOAc/Na0H 7=None Temp °C Initials <br /> esrxr <br /> -1'Z" <br /> w.� 2 <br /> "4"-a6E 03 1016 524 2 .Page_of- <br /> 1Z 954 2 <br />