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4080 PIKE LANE, SUITE C HAIN-OF-CUSTODY RECORD W0322 <br /> IGTEL <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> (51 a) 685-7852 <br /> �:• ■'• "; (800) 423 7143 1 <br /> Company Name Phone # <br /> UJ <br /> X FAX # ❑ ❑ m LI <br /> —Company Address Site Location m ❑ cc [4 <br /> ❑ ❑ ❑ H cr o <br /> o �, N U ❑ I �� <br /> Project Manager ient Project ID (# n ❑ r <br /> j g }�d��3 �� ❑ Q 75 <br /> a w m m O ~ n m <br /> x <br /> A - m �_ Cl ❑_ OJI p ❑ z z ❑ ❑ ❑ Cr <br /> attest that the proper field sampling Sampler Name(Pnn) ❑ �' o c ❑ ❑ m E ° ❑ m <br /> d N ❑ .q ❑ Q ! (.� N ❑ <br /> procedures were used during the c� 9 L) o C4 ❑ ❑ � t H ❑ d vii © s <br /> collection of these samples a .- <br /> O N m 0. 0 o rev 0- Q r- m ¢ ❑ tl <br /> Method `" m Q m c ❑ co w ❑ p ° o 0 o fu <br /> H <br /> Matrix Sampling o v O m ❑ a a o D m p d k N f] <br /> cr Preserved m �. a r ❑ w w m -� m H H Cl b �] <br /> Field GTEL w ❑ x = _ ❑ a s d H <br /> z H N N n 01 m o D ❑ ❑ a R ❑ g 'o "' J ? <br /> Sample Lab # a W U a N o x d n IJ <br /> }- 7 ([ �,, O O N N N yO <br /> ID tab Use z w p O w w°u Wr W w X <br /> l/ O ►- J 0 2 O a> z- H w w a o x m a ¢ ¢ ¢ a a a f J a m o <br /> Only U a 0 ¢ �� rF i- U z `� iw F a F F a r — a Q a a- a a s M a- a U a s y o <br /> 2 �n O.. O P m m 2 z O F- W W W W w W W W W t- W U J O U <br /> 300 <br /> ✓ ( X X 112 I <br /> lc7rT <br /> ✓ to <br /> ✓ t� <br /> 19M, x - <br /> ✓ 12AD x <br /> PLO <br /> TAT, Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> Priority(24 hr) [I GTEL Contact <br /> Expedited(48 hr) 171 Ouote/Contract# <br /> 7 Business Days CI Confirmation N <br /> Other— SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot p Storage Location <br /> Business Days 1-I PO 4 <br /> 0A/0C Leve <br /> Blue❑ CLP L7 other E _ �_...._— FAX❑ Work Order ti <br /> Relsn wsh d by Sa pier Date Time Receiveby <br /> CUSTODY <br /> nLC��U Relinquish d by � Date Time ReceivecFby <br /> Relinquished by Date Time Received by Laboratory <br /> Wa bill� <br />