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4' <br /> 4080 PIKE LANE,SUITE C CHAIN-OF-CUSTODY RECORD <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST 37120 <br /> GTEL/ (510)685-7852 <br /> IA101,I6H1 . (800)423.7143 <br /> Company Name: Phone#: 9/6 72—g7c7c� <br /> Gr0U4WJ'1-r- 7e l FAX#: i -7?;2 -d-7rt CI © - ❑ <br /> Com any Ad ress: Site Location: , m m ❑ <br /> iyo� rrvy��P br. S -/yo `� sTa T CA 5 '2 0 f-] El m ° L <br /> Cil t m 8 � i g a ❑ ❑ CI <br /> Project Manager: Client Project ID:(# ❑ 19 ± ± 2 -J <br /> s x10.70 O/ 6�7 © ❑ rn m m m a ►a- a <br /> / Sd� w o ❑ 0 C� C] z z L7 0 ❑ to . ¢ <br /> attest that the proper Heid sampling Sampler Name(Print): a o " ❑ ❑ o �� E ; cLit ❑ <br /> procedures were used during the $ rs N ❑ ❑ m a a :s "' s c <br /> collection of these samples. B/�LtG�- �_- o v, a a o o a- �, ❑ a m 0 as <br /> ❑ u m011 <br /> Method c3 - " nr m a a CO C) +'*„� Cl Cl € u� r$ olow <br /> Matrix Sampling v ch a ❑ D w a a o ❑ ❑ '" ❑ a N ❑ <br /> Field GTEL Preserved © V n w w 0 -J a m �, ❑ ❑ .. <br /> Sample Lab# a ,u v N R a �; N a a o m <br /> 1- [[ Cry 7 ¢ o ¢ ['3 m v ff �' w m mC%J IA O m Al <br /> IQ Lab Use z w d e w g o ¢y T` F w w w a m a a a a a a a ►- a <br /> Only a o ¢ U z y w `z¢ r a r F > a — a 0 a a s (L 0. a a a a m o <br /> a 3 rn a m a O x x 2 V �'� O� a f m as ¢ z O r w w w w w w w w V O V <br /> DZ <br /> :x <br /> 1211+ :K 9• `._ <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS: <br /> Priority(24 hr) ❑ GTEL Contact <br /> Expedited(48 hr) C) Quote/Contract 9 <br /> 7 Business D_ a}} Confirmation 9 <br /> Other <br /> PECIAL REPORTING REQUIREMENTS Lab Use Only Lot tl: Storage Location <br /> Business Days C] P.O.# S <br /> QA1QC Level � <br /> Blue❑ CLP❑ other 0 FAX❑ Work Order#: lrr-5 0 c? O O5G <br /> Relinquished by Sampler; D e Tim Received by: <br /> CUSTODY 6 v' <br /> RECORD Relinquished by: e Time Received by: <br /> �P-- -71719E 1. Z3 <br /> Relinquished by: LOAa Time Receive by Laboratory: <br /> q <br /> r Q Z.a Wa bill <br /> �. <br />