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ANVA 2795 Second Street, Suite 300 Cal Science Environmental <br /> Davis,CA 95616 7440 Lincoln Way <br /> Lab: 530.297.4800 Garden Grove, CA 92841 � <br /> ANALYTICAL LLO Fax: 530.297.4808 714-895-5494 Lab o. y Z ` ("® ge --I- of -L <br /> Project Contact(Hardcopy or PDF to): Geotracker COELT EDD REPORT? Chain-of-Custody kqcord and 6pKsis Request <br /> J221 i _YES _X NO <br /> Company/Address: 21 a <br /> Kiff Analytical, LLC Sampling Company Log Code: Analysis Request ® a <br /> Phone No.: FAX No.: Global ID: <br /> Project Number. P.O.No.: EDF O <br /> Deliverable to(Email Address): U <br /> T '. <br /> 206-0783-001 40904 04 o <br /> Project Name: E-mail address: co N N w <br /> 2575 Count Club Blvd., Stockton linbox(M-kiffanalytical.corn co z <br /> Project Address: Q E <br /> Sampling Container Preservative Matrix W CL Q > `o <br /> Sample o d ° °° > Z U. <br /> Designation Date Time a s n ° 1 a U s z 3 0 a a U Z <br /> H-1-8.0 11/5/04 3:00 1 X X X X <br /> H-2-8.0 11/5/04 3:10 1 X X X X <br /> T-3-10.0 11/5/04 2:30 1 X X X X X <br /> Relinquished by. rate Time Received by: Remarks: <br /> o ; /10'rev tlx <br /> Relinquished Date Time Received by: <br /> Relinquished by: D to TI Received ry _ Bill to: <br />