Laserfiche WebLink
EMCON/OWT Inc. CHAIN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM Page_of— <br /> o��O�1326 North Market Boulevard Sacramento P.O.# Direct Bill to San Joaquin County CA 95834 Lab: CAS,Cana a Park,Ca <br /> Project Name:North County Landfill,San Joaquin County Analysis Requested <br /> Project Number: 791288 (Ground Water) <br /> Report to: Sheila Richgels c <br /> s <br /> <Sheila.Richgels cr Shawgrp.com> v v <br /> Company: EMCON/OWT Inc. w <br /> Address: 1326 North Market Boulevard o <br /> c � <br /> d <br /> Sacramento,CA 95834 o II n Z <br /> Dir Ph: (916)565-4327 / FAX: (916)5 -4356 N z :a <br /> o U M °d <br /> Sampler's Signature: a A e£ <br /> W z U U r;6 1 REMARKS <br /> Sample LAB Sample 1 4 3 Container Types <br /> I.D. Date Time I.D. Matrix HCl NP HNO3 Preservations <br /> G-1 (.� water 5 3 1 1 <br /> G-3D I.9ke ci� water 5 3 1 1 <br /> G-4 1+99,16 IA" water 5 3 1 1 <br /> G-5 1 t� 9-50 water 5 3 1 1 <br /> G-6 •�� .3 water 5 3 1 1 <br /> 1a ld Blank <br /> 1�+ ' 1•D 1� water 2 2 <br /> Trip Blank )• +SIA water 2 2 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY REGEIVFpY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X 1. Routine Report <br /> Si tur Signature Signature ignature 24 hr 48 hr 5 day 11. Report(includes DUP,MS <br /> lahA I VIM�1 - N4 ( X Standard(-10-15 working days) MSD,as required,may be <br /> PfFt)d Nam Printed Name Printed Name Printed Name Provide Verbal Preliminary Results charged as samples) <br /> "00 1 Provide FAX Preliminary Results III.Data Validation Report <br /> F1 Firm Firm Firm Requested Report Date: (includes All Raw Data) <br /> t(� X RWQCB <br /> Date/Time b'%-06 Date/Time Date/Time Date/Time (MDL,,/PQU/TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key: <br /> Report MDLs,PQLs,and Trace. Columbia Analytical 40 mi VOA: 1 <br /> Signature Signature Nitrate Nitrogen has a 48-hour hold time. 6925 Conaga Avenue 250 ml LPE: 2 <br /> Canoga Park,Calif 91303-3102 500 ml LPE: 3 <br /> Printed Name Printed Name Lab Contact: Karen Ryan i liter HDPE: 4 <br /> 818-587-5550 x310 500 ml glass: 5 <br /> Firm F""' Fx.818-587-5555 1 liter glass: 6 <br /> Ship FedX Acct 1435-1381-5 2x6 s/s ring: 7 <br /> Date/Time Date/Time glass jar. 8 <br />