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EMCON/0WT Inc. CHAIN OF CUSTODY/LO LABORATORY ANALYSIS REQUEST FORM Page a of 1326 North Market Boulevard Sacramento �0 P.O.No: 74815 CA 95834 Lab: CAS,Canoga Park,Ca <br /> Project Name:North County Landfill,San Joaquin County Anal is Requested <br /> First Storm Event 2005/2006 Season <br /> Project Number: 791288/00005000 s <br /> Report to: Sheila Richgels <br /> Company: EMCON/OWT Inc. <br /> Address: 1326 North Market Boulevard o <br /> Sacramento,CA 95834 U U <br /> Phone: (916)5654327 / FAX: (916)5654 6 C 1 Z <br /> Sampler's Signature: 41. <br /> o <br /> Sam le REMARKS <br /> P LAB Samp e 4 Container Types <br /> I.D. Date Time I.D. Matrix NP Preservations <br /> S-1 1-3 103-!r' water 2 2 <br /> S-2 10Aa' water 2 2 <br /> S-4 water 2 2 <br /> RELINQUISHED BY RECEIVED BY p RELINQUISHED BY RECE4VEDY TURNAROUND REPORT REQUIREMENTS <br /> %ff REQUIREMENTS X I. Routine Report <br /> Signa Signature Signature S-gnature , 24 hr 48 hr 5 day 11. Report(includes DUP,MS <br /> f� X Standard(-10-15 working days) MSD,as required,may be <br /> PLilted Na aPrinted Name Printed Name Printed Name Provide Verbal Preliminary Results charged as samples) <br /> F1v »� Provide FAX Preliminary Results III.Data Validation Report <br /> Fi Firm Firm Requested <br /> r� '�'Z F p ® Report Date: (includes All Raw Data) <br /> X RWQCB <br /> Date/Time 1-:3-oDate/Time Date/Time Date/Time -2—(MDLs/PQLs/TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Y�A Container Types Key: <br /> Columbia Analytical 40 ml VOA: i <br /> Signature Signature Report MDLs,PQLs,and Trace. 6925 Conaga Avenue 250 ml LPE: 2 <br /> Nitrate-Nitrogen has a 48-hr hold time. Canoga Park,Calif 91303-3102 500 ml LPE: 3 <br /> Printed Name Printed Name Lab Contact: Stuart Sigman I liter HDPE: 4 <br /> 818-587-5550 x310 500 nil glass: 5 <br /> Finn Firm 818-587-5550 <br /> 818-587-5555 1 liter glass: 6 <br /> Date/Time Date/Time ShipFedX Acct 1435-1381-5 2x6 s/s ring: 7 <br />