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4060 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST 37110(510) 665.71352 <br /> PGTEL <br /> (800) 423.7143 <br /> , � 1 1 <br /> Company Name: r Phone#:(114)371—rl7'Da <br /> G rdiu14-LtQV) er' Je A 14 01!7 4 FAX a: 1-9 372- -,P -- ❑ ra v ❑ <br /> Com an Address:/ Site Location, <br /> p�� f �'ra rt¢ ���4 ���arjtk�n7w�t ![ u n ❑ LI ❑ ir oo� <br /> N N � �O <br /> w <br /> o_ ❑ <br /> L (/J <br /> Project Manager: CA Client Project ID: (#) ❑ to N L3 ❑ a ❑ <br /> ff?1 Jf nZd7n o/3� 6 sa y EI o d N uy a r a c <br /> t]l�1<Gt1 Cs e"1UC!` w o ❑ ❑ ❑ ❑ z z ❑ ° C]INAMEI ^ v <br /> I attest that the proper field sampling Sampler Name(Print): a in M g r ❑ ❑ m .E Ll o <br /> procedures were used during the `�0 CI "', ❑ ❑ m ¢ a N o -' � c <br /> collection o1 these samples. �/t ti! { # q +!� ❑ a o 0 0 a o ❑ a ❑ a <br /> Method Iv 19 - w m a W m ❑ m ❑ C > = c❑� <br /> Matrix Sampling o r, Q n © v a a a 0 ❑ ❑ ' r� 0 UL <br /> Field GTEL w Preserved C R ❑ 0 ui w w 0. 0. d ❑ R ❑ <br /> z a O m r ❑ ❑ ❑ ❑ {9 N ~ <br /> Sample Lab # ¢ w Cr. x eD (�� C7 v T p N m 4 X N m C <br /> IO Lab Use z w p a w d w,pi, w w w x c n `3 c� ` `� cn O N c m <br /> 1 0 ¢ ¢ oCr <br /> > x r- w w o m a a a a a a a r a '01 1 <br /> ] hx u z �' w ear a 1 P r > 4 0 a a a b as a n. a U a a `� $ o <br /> only R 3 roi^j a rn a O x x U �� 0� n F ca m x x o r w w w w w w w w w r w v �� u <br /> 1177 O — <br /> ?I x Tau 0-2, od <br /> 03 _ — <br /> 3n.11�y��pS.Qnd,� U` °y <br /> ��'' I - <br /> -��Ta� - <br /> �C72 <br /> 08 Lk4 <br /> L 14 — <br /> LL <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS: <br /> Priority(24 hr) (1 GTEL Contact <br /> Expediled(48 hr) 1.1 QuolelContracl# <br /> 7 Business pa s I-I confirmation# <br /> other --- )".— SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot C Storage Location <br /> Business bays cl P.O. # <br /> VC <br /> QA1GC Level 5 <br /> issue l l CLP 1.] Other t,)_ FAX[] Work (der#: <br /> Relinquished by Sampler- OD <br /> Time Receive by: <br /> CUSTODY Relinquished b Y Time Recelve by: <br /> RECORD Relinquished by: Time Received by Laboratory. <br /> Waybill 9 i <br />