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{ <br /> 4080 PIKE LANE, SUITE C CHAIN-OF-CUSTODY RECORD 4 Q 3 21 <br /> CONCORD CA 94520 AND ANALYSIS REQUEST <br /> (510) 685 7852 <br /> jGTEL <br /> (800) 423 7143 1 1 <br /> Company Name Phone <br /> CY' FAX 0 ❑ <br /> Company Address Site Location f� ❑ 3z cc <br /> ❑ [Q <br /> CV V <br /> Project Manager Client Project IBJ (ft) ��U(33 ❑ + * D ❑ a <br /> 4 ❑ cn of v� N <br /> L,ta ) S-rHC- Th ' o ❑ ❑ ❑ ❑ zz 0 ° ❑ <br /> aticst that the proper field sampling Sampler Name(Print) a o ❑ o ❑ o Q u) 3 U 41 <br /> procedures were used during the f]L ; o c7 ❑ o n' N ❑ © cmi >~ m ❑ ix c~n o <br /> collection of these samples it n fl_ M a o 0 o a 4 m a <br /> o u LL m " m ¢ 6 W Li m [o ❑ O <br /> Matrix Method Sampling o o n- ¢ ¢ , ❑ � ' a J N ❑ LL <br /> Field GTEL _ Preserved o 1 � ❑ EI w w M a a 2 M N 1� r <br /> K ti a n a m m o ❑ 0 Q a a ❑ 2 � m m N � � <br /> Sample Lab # K W U o 2 6 in N w * o X a m �; <br /> F" (C D !r ,D CD v u T} rf �' d D Q O N N G T2 N u, <br /> f Z W C1 W n w� W D O C D vl ,D W ,D rD W [D Q d � C 2 <br /> Il] Lab Use D °C J (Z r- () tu <br /> O V i� F ¢ 2 1- T T d ❑ 6 d d d P. 0. rL a U iL ¢ w O <br /> 1 3 rn v� a O x x x _ �m O_ o E m x = O s- u+ w w w w w W w w r- w U O U _ <br /> rav8 <br /> y I I <br /> 'T <br /> lweSt 05 ,' I iZ J( <br /> 77 <br /> ✓mow 5C <br /> 0-? <br /> a r <br /> mw- <br /> ✓_div—IC[— » +-- 11 1 <br /> I It --JF <br /> M� Fit? <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> r,,,n„iv(24 fir) GTEL Contact <br /> E■peditr'd(48 hr) Ouote/Contract p <br /> 7 Business 01iq <br /> Confirmation if <br /> Other ___ <br /> thens n,ys P O R SPECIAL REPORTING REOUIREMENTS Lab Use Only Lot# Storage Location <br /> RiisjnrqQA/0C Level �A <br /> Big:n CLP i ' Oihrr i i _ �__ 1 FAX[] Work Order# <br /> Rehnquist d Sam erI D tQ Time Receiv by <br /> CUSTODY Relinqutshe y Date Time Received by <br /> RECORD as, - / <br /> Relinquished by V Dat Tim <br /> Received by Laboratory ' <br /> r a Oi <br /> Waybill# <br /> r <br />