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4080 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD <br /> GTEL CONCORD, CA 94520 AND ANALYSIS REQUEST 37110 - <br /> Io .,.... (510) 685-7852 <br /> (800) 423-7143 , <br /> 1 1 <br /> Company Name: r Phone N:(y/4)32L <br /> ol� �w e e��K 61 FAX #: /1' ?7 . - 7y� r� r� ❑ <br /> Company A dress:/ �y r Site Loc tion: /J f� m ;, ❑ <br /> li/D/ #a.-(y00'K U1 . T,�r�Q �4 %a�+p/a�rrc /[tX. ini: 0 ❑7 ❑ ❑ 0 QU o <br /> rA <br /> a ❑ `$ ❑ <br /> Project Manager: s Client Project ID:(N) ± ± ❑ a El 4 <br /> llI`1�Ge� Geel6cir- gZo7p o/33 6S7m - n ❑ ❑ ❑ El z z p ❑ a <br /> I attest that the proper field sampling Sampler Name(Print): a ❑ m $ 1 ❑ ❑ d Ea- 0 b ❑ o d <br /> procedures were used during the y _ / S r❑., ; © ❑ © a a u U) c F Lc <br /> collection of these sam les. b 1�ted ��"'� 3 �° a r? �l a Q o N a n m Q a r" ❑ a <br /> ❑ m ]L w ri U ' o o ❑ - w ❑ Q- O ❑ r~ L <br /> Matrix Method Sampling o :p o 0 a- a a m © [0 ❑ > 0 a 8 ro <br /> Field GTEL z Preserved _ ❑ ❑ w w w a: ii m y12❑ N p n <br /> Sample Lab# a N e9 v4 <br /> a N El a o _J <br /> Ila Lab Use o _,-: o °o w o o q; it F . w w w o v % 'm a a a a a a a ►- °� a ' <br /> only V a 0 ae _J a: z `� L $W r a F t- T - a a a a s a n 0. 0. M U u. Q d a i <br /> a � (n a w a 0 z x x _ am 8e Q F m m x � O h w w w w w w w w w F w U 3A 0 U <br /> 117'7 lke-Zq 0.1. 3 Y_ X � °� <br /> (` l O Ivo <br /> i �33G� <br /> 03 — — Oy — <br /> CS� � U <br /> q Q err <br /> 1M_1Llft W 0-7 <br /> iiGr�e <br /> 00 <br /> Oq <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS: <br /> Priority(24 hr) t.I GTEL Contact <br /> E]pediled(48 hi) LI OooietContract# <br /> Business Das 11 I Confirmation# <br /> Olhll�rl— )L� _F_ SPECIAL REPORTING REOUIREMENTS Lab Use Only Lot q: Storage Location <br /> Business Days Ll P.O. # <br /> 5 oG <br /> OA/QC Level <br /> Blue( I CLP U Other(A FAX❑ Work Order#: <br /> Relinquished by Sampler al Time_ Receive by: <br /> CUSTODY <br /> Relinquished b pie Time Receive by; <br /> RECORD 1�? <br /> Relinquished by: Date Time Received by Laboratory: <br /> M-5 1 12Waybill# <br /> r <br />