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Room <br /> {I <br /> 4 l <br /> ��� � 4080-Pike lane CHAIN-CIF-CUS'�P.'DDYRECORD -� CUSTODY RECORD <br /> Concord,CA 94520 800.544.3422(In CA) AND ANALYSIS EOUEST / 2- -"t-J-92 <br /> tib a Ne DOR t1547Ac <br /> 1,415-685.7852 800.423.7143{Outside CA} ANALYSIS REQUEST <br /> Project Manager. Phone 572- ❑ 1 <br /> -Add4reiTls!sz: �—u!jrlflb-J��17����Y'Z�1*�>tI-•'-L/-e-GL�I.+S! #C-1y-��I _ _V,• L F• f�m) 4. a w❑Q� C ❑ III fI C <br /> M <br /> I�v <br /> 0FAX n: 2t7cYLIl 11 ❑ ❑Site to 1 Za ;lIn-^ p <br /> 14 <br /> Project Num r.. 4R Project Name: N } ❑ Q 4 m �� �n ❑ ❑ o ' <br /> I//�-�-� p N ct EL .I CO m `'' <br /> _ i-1-TooL - - r•?71}1.Ei4-5 Y -- -- 3 ❑ 0 � n a z a ❑ 1 <br /> l.Rest I t the proper fisampli g . Sampler Name(Print}: m r ❑I2 I o - <br /> procCdures were used during the collection a1� 1 (�G ❑ v io III a e I c ;L) <br /> ot these samples. r.1� �-� o u G �jplolo o�o�o ❑ ��' °im: L <br /> Field Source G7EL Matrix Method Sampling m ° a N m i Q ❑ o d I n; �� .1 <br /> u1 Preserved +6 i^' o o o r� cv T 2 I <br /> Sample Of I <br /> Lab ❑; V .Y��I mro w m ¢4m - n ❑j .�j�'+ jr h <br /> ! ID samniP f _ wl Tom- N.y ❑lu QI❑ ❑ f7 ❑ ❑ G 2 ` moizl "i ^ 'o �71 D` '{ <br /> H ¢ r7 ¢ ¢ .. a- mu _ ��nooa 'vcxe � nl� 5 . "� c � > <br /> onlyl z w o w O w w to w x m a a m m m o c n p q + t7 a, �! = _ <br /> I/ <br /> u a '¢ x rn w z M r w w x o m a a a a a a a l r <br /> Rr I O_ w r v V O 4 f- r a o o a a a n. i a a U a W•-i 8'' <br /> i u Ina 00 S x = y z 0 f- m m r- 4 r r w w w w w w w r l w j w;ut"t) <br /> Li �'` <br /> 4VTI <br /> I'll N <br /> SPECIALHANDLING SPECIAL DETECTION LIMITS Specify) g M RKS: �F /k�t.r�5 SJ�vt,vy <br /> 24 HOURS CJ / f t7lS5vWL43 l37 FJ,�(`TP/�-�� <br /> EXPEDITED 48 Hours ❑ r 1 l�14 1 $ MW-5 m ) <br /> C <br /> SEVEN DAY ❑ I � �� ' '_n m s <br /> OTHER(4) BUSINESS BAYS a <br /> QAlOC CLP Level❑ Blue Level Q AL <br /> SPECIAL REPORTING RECUIREMENTS Lab Use Only Storage Location a <br /> FAXX (Specify) _� c <br /> Lot#k: Work Order x: 1`-E S E <br /> 1 <br /> II � <br />