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L <br /> 4000 rlKE LANE, SUI FE C r CHAIN-OF-CUSTODY RECORD <br /> IGTEL CONCOnD CA 94520 AND ANALYSIS REQUEST 37 <br /> (510) 685 7852 <br /> •�• �, "' 7- <br /> (800) 423 7143 <br /> ANALYSIS <br /> Company Name Phone # 'Z �_[� 015 <br /> GPOc��� � a. FAX # f6 7 ,�7�"/ ❑ ❑ <br /> 7 � �/6GKf, Orimr <br /> CompanySite Location gi/a © . x a❑ <br /> ❑ <br /> / /n1 f/'t �« X dr f Q <br /> W � �,19z _ <br /> v a ❑ <br /> Projecl Manager Client Project ID (#) # ❑ g U Z' <br /> (jIAMEI .ST�r� :�o CL 0 <br /> m G. 6Ej o ❑ ❑ z z ❑ ° CJ o <br /> :ltlr'sl sinal thr,proper[mid s'lrnpirng Sampler Name(Pnnt) ❑ n C] t] m <br /> - ❑N ma=' 0 on <br /> ❑� RcYi ❑ <br /> ¢ <br /> N E U <br /> procedures were usod during ilia n m <br /> collection of these sam IesFir- T ❑ ❑ m ¢ El <br /> ao D o q ' c <br /> a as. <br /> mam � � a <br /> ,n MatrixMethod 0 N o Cl 0 -5 Sampling > <br /> Preserved co © o ❑ ❑ <br /> co a aa 0-Field GTEL c <br /> W W Co a - °° � �^ © m ❑ <br /> Sample Lift) ff a IU V N � C � m m � (may I� ❑ ❑ a t1 ❑ � @ 5 N N J Z <br /> ID Lab Use CrQ ¢ t6 T O o N N N c X m m N Y <br /> F- _ <br /> Z w p O w W�' w� w W a n N rD m m m O N c <br /> 1 ° '' J O U S w ga y}( w „ _� = m Q g q q q a q � a o <br /> only w a i a O T x x V §�l or" 0 r m w z T O r w w w w w w w w w i°- w U _3 0 U <br /> - <br /> �a Z4 ri` 0 <br /> ' - 'YS" Zs plus <br /> _P _ � 2L <br /> 04 <br /> ;[o <br /> 2-7 <br /> Z� I to <br /> 0 33 3o <br /> TAT Special Handllr g SPECIAL DETECTION LIMITS REMARKS <br /> Pnrnniy 124 hr) r ' CTFL Conlic-I <br /> Fyp"d-14(i 148 h,l Ouole/Contract k <br /> ntrsmWD,Ou,nrConfirmation 9 <br /> Dus Hess Dlys POM __ SPECIAL REPORT NG REQUIREMENTS Lab Use Only Lot# Storage Location <br /> QA10C Level 3 of 4 <br /> Nun, i CLP 01hAl ' FAX❑ Work Order# C 5 O <br /> nerinqurst1 --- <br /> Sampler Date Time Received y <br /> CUSTODY � `��' IIN - ddA <br /> Plehnquished by Dale Time Recerve y <br /> RECORD W R-A!i-sd ILlo <br /> Flehriquis�by Date Time Received by Laboratory <br /> t(v " 40 1 Waybill 9 <br />