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CHAIN OF CUSTODY/ LABORATORY ANALYSIS REQUEST FORM Page_of_ <br /> Shaw Environmental P.O.No: Direct Bili San Joaquin County <br /> 1326 North Market Boulevard,Sacramento,CA 95834 Lab: BC Labs,Bakersfield <br /> Project Name:Foothill Landfill,San Joaquin County Analysis uested <br /> 1st Quarter Sampling 2010 <br /> b <br /> Project Number: 124591 (Surface Water) �0 <br /> Report to: Sheila Richgels,Shaw Environmental <br /> <sheila.richgels@shawgrp.com> 916-565-4327 N <br /> CC Report to: Jody Rhoades,Shaw Environmental v Q w <br /> <jody.rhoades@shawgrp.com> 916-565-4362 0 z ' <br /> u � <br /> Sampler's Signature: Cn <br /> Z z U REMARKS <br /> Sample LAB Sample VOA Lite,LPE 250nil500ml I IContainerTypes <br /> I.D. Date Time I.D. Matrix HCI NP NP HNO3 Preservations <br /> S-1 water 6 3 1 1 <br /> S-2 water 6 3 1 1 1 <br /> RELINQULSHED BY RECEIVEJ BY RELI QUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X I. Routine Report <br /> Signature Signature Signature Signature 2411 -(-10- <br /> 4811 _5 day II. Report(includes DUP,MS <br /> —y—standard(10.15 working days) MSD,as required,may be <br /> Printed Name 'nted Name Printed Name Printed Name Provide Verbal Prelunina Results charged as samples) <br /> rrovide FAX Prclinihidry Results III.Data Validation Report <br /> Firm Firm Firm Firm 'RequestedReportDaW (includes All Raw Data) <br /> X RWQCB <br /> Date/Time Date/Time Date/Time Date/Time (MDLs/PQLs/TRACE#) <br /> RELIN4fUISHED BY RECEIVED BY Special Instructions/Comments: Container Types Key: <br /> BC Labs-Tina Green 40 ml VOA: 1 <br /> Signature Signature Please report MDLs,PQLs and Trace. 4100 Atlas Court 250 ml LPE: 2 <br /> Nitrate-Nitrogen has a 48-hr hold time. Bakersfield,Ca 93308 500 ml LPE: 3 <br /> Printed Name Printed Name 661-327-4911/Fx:327-1918 1 liter HDPE: 4 <br /> Ship via UPS Acct 965376 500 ml glass: 5 <br /> Firm Firm Field Support: Peter Bins Iliter glass: 6 <br /> EDDs to Gvusan.vvaterntan@shawgrp.com> (408)391-2942 2x6 s/s ring: 7 <br /> Date/Time Date/Time glass,jar 8 <br />