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CHAIN OF CUSTODY i LABORATORY ANALYSIS REQUEST FORM Page_of <br /> Shaw Environmental P.O.No: Direct Bill San Joaquin County <br /> 1326 North Market Boulevard Sacramento,CA 95834 Lab: BC Labs,Bakersfield <br /> Project Name:Foothill Landfill,San Joaquin County Anal 's Requested <br /> 1st Quarter Sampling 2010 <br /> Project Number: 124591 (Lysimeters) 8 <br /> Report to: Sheila Richgels,Shaw Environmental o <br /> <sheila.richgels®shawgrp.com> 916-565-4327 N �, <br /> CC Report to: Jody Rhoades,Shaw Environmental ° 00a �+ <br /> U d ca v <br /> <jody.rhoades@shawgrp.com> 916-565-4362 w W o w <br /> o <br /> Sampler's Signature: <br /> z z Up �0 REMARKS <br /> Sample LAB Sample ;s;- VOA 1 LPE zsomt sooml 1 lContainerTypes <br /> I.D. Date Time I.D. Matrix xcl NP IVP euros Preservations <br /> LZ-01 water 6 3 <br /> LZ-02 water 6 3 1 1 �- <br /> LZ-03 water 6 3 1 1 1 <br /> LZ-04 water 6 3 1 <br /> �f <br /> RELINQUISHED BY RECEIVED BY �,. RELINQUISHED BY RECEIVED BY. TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X 1. Routine Report <br /> Signature Signature Signature Signature 24 hr _481v _5 day ; II. Report(includes DUP,MS <br /> X stau lud s w kiag clays) MSD,as required,may be <br /> Printed Name ed Name Printed Name Printed Name Provi&Verbal Pmlhw nary Resucta charged as samples) <br /> Provide PAX Prelittthtary Resects III.Data Validation Report <br /> Firm Firm JFirm Requested Report Date: (includes All Raw Data) <br /> X <br /> Date/Time Date/Time Date/Time Dato/TimRWQCBe (MDLs/PQLs/TRACE#) <br /> RELINQUISHED BY RECEIVED BY Speciallnstructions/Comments: Container Types Key: <br /> nature PlBC Labs-Tina Green 40 nil VOA: 1 <br /> Signature Sigease report MDLs,PQLs and Trace. 4100 Ades Court 250 nil 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 /> Finn Firm FicldSupport: Peter Bins lliter glass; 6 <br /> EDDs to<susan.waterman®shawgrp.com> (408)391.2942 2x6 s/s ring: 7 <br /> Date/Time Date/Tirae glass jar 8 <br />