Laserfiche WebLink
w w w w w w w ww w w w w w <br /> CHAIN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM Page_of_ <br /> Shaw Environmental P.O.No: Direct Bill San Joaquin County <br /> 1326 North Marken oulevard,Sacramento CA 95834 _ �9 � � Lab: CAS,Simi Valley <br /> Project Name: Foothill Landfill,San Joaquin County Analysis Requested <br /> Project Number: 124591 (Resample) <br /> Report to: Sheila Richgels C' <br /> <sheila.richgels@shawgrp.coYn> q <br /> Company: Shaw Environmental <br /> Dir Ph: (916)565-4327 / F ( 6)56 4356 tr j <br /> 0 0 <br /> 0 d) <br /> Sampler's Signature: 0 0 <br /> El <br /> Q 7'1 <br /> � E~ REMARKS <br /> Sample LAB Sample VOA JContainerTypes <br /> I.D. Date Time,- I.D. Matrix HCI Preservations <br /> MW-3. -95'� Q23 water 3 3 <br /> Trip Blank -;,cn N iq 2 water 2 2 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY REC EI B TURNAROUND REPORT REQUIREMENTS <br /> 1 &0"9 Z// *�Iln i— REQUIREMENTS X I. Routine Report <br /> Si r Signature Signature LJ =KJ1157 <br /> e 24 hr _48 hr _5 day Il. Report(includes DUP,MS W k' <br /> - X Standard(-10.15 working days) MSD,as required,may be <br /> "tid Name � Printed Name Printed Name Printed Name Provide verbal Preliminary Results charged as samples) <br /> Provide FAX Preliminary Results III.Data Validation Report <br /> Firm Firm Firm Fi Requested Report Date: (includes All Raw Data) <br /> �� X RWQCB <br /> Date/Time Zj Date/Time Date/Time Date/Time (MDLs/PQLs/TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key: <br /> Columbia Analytical 40 ml VOA: I <br /> Signature Signature Please report MDLs,PQLs and Trace. 2655 Park Center Drive,Suite A 250 ml LPE: 2 <br /> Simi Valley,CA 93065 500 nil LPE: 3 <br /> Printed Name Printed Name 805-526-7161/Fx 805-526-7270 1 liter HDPE: 4 <br /> Contact: Karen Ryan 500 ml glass: 5 <br /> Firm Firm UPS Acct 9653EI I liter glass: 6 <br /> EDDs to Gsusan.waterman@shawgrp.com> 2x6 s!s ring: 7 <br /> Date/Time Date/Time glass jar 8 <br />