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CHAIN OF CUSTODY/L.ABORAT ANALYSIS REQUEST FORM Page—of_ <br /> EMCON/OWT Inc. P.O.No: 211868' <br /> 1320 North Market Boulevard,Sacramento,CA 95834 Lab: Sequoia Analytical,Sacto <br /> Project Name:Foothill Landfill,San Joaquin County Analysis Requested <br /> Project Number: 791289/00001000 ! <br /> Project Manager: Steve Glacomini <br /> Company: EMCON/OWT Inc. <br /> Address: 1326 North Market Boulevard <br /> Sacramento,CA 95834 a <br /> Dir Ph: (916)565-4335 / FAX: (916)565-4356 <br /> w � � <br /> Sampler's Signature: <br /> v ° REMARKS <br /> --Sample Sample 3 3 Container Types <br /> I.D. Date Time I.D. Matrix I I NP HNO3 Preservations <br /> MW-1 &&-163 1450 water 2 1 1 <br /> MW-3 7075- t;,ZS water 2 1 1 <br /> RELIQUISHED BY RE IVSD BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> C✓,,' REQUIRE X I. Routine Report <br /> Signature Signature Signature Signature 24 hr _4! II. Report(includes DUP,MS <br /> standard t—la-1s7.workinZga <br /> MSD,as required,may be <br /> i <br /> Printed Name Printed Name Printed Name Printed Name Provide Verbal Preliminary Results charged as samples) <br /> 014`(/b,J_V( Provide FAX Preliminary Results 1H.Data Validation Report <br /> GFiirrp 3 Firm�(�'Io —ni, n Firm Firm Requested Report Dale. (includes All Raw Data) <br /> No 3 6q 5-v �y_ X RWQCB <br /> Date/Time Date/Time Date/Time Date rime (MDLs/PQLsn RACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key: <br /> Sequoia Analytical 40 ml VOA: 1 <br /> Signature Signature Please r ort MDLs,PQLs and Trace 819 Striker Avenue,Ste.8 250 ml LEE: 2 <br /> Sacramento,Ca 95834 500 ml LPE: 3 <br /> Printed Name Printed Name ra n G 916-921-9600 1 liter HDPE: 4 <br /> � Contact: Ron Chew 500 nil glass: 5 <br /> Firm Firm 1 liter glass: 6 <br /> 2x6 s/s ring: 7 <br /> Date/Time Date/Time glass jar: 8 <br />