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r rr rr wr rr r r� rs <br /> (: INT OF CUSTODY I LABORATORYANALYSIS REQUEST FORPage—of <br /> Shaw Environments! P.O. Direct bill to San Joaquin County <br /> 1326 North Market Boulevard,Sacramento CA 95834 (O Lab: CAS,Simi Vail! <br /> Project Name:Corral Hollow Landfill,San Joaquin County Analysis Requested <br /> Project Number: 124592 (Ground Water) <br /> Report to: Sheila Richgels <br /> <She1la.Richgels@Shawgrp.com> w d <br /> � w <br /> Company: Shaw Environmental 01ti <br /> Address: 1326 North Market Boulevard <br /> Sacramento,CA 95834 48 _ <br /> o a, <br /> Dir Ph: (916)565;Date <br /> (916)56 -4356 c Z o ri <br /> U � <br /> R .t1 A <br /> Sampler's Signature: Z y d <br /> REMARKS <br /> Sample LAB Sample 4 125m1 1 Container <br /> Types <br /> I.D. Time I.D. Matrix NP' NP xcl Preservations <br /> MW-4 -.%o LQiZ I water 5 1 1 3 <br /> MWS + water S 1 1 . 3 <br /> SB-1 -yV2.3 water 5 1 1 3 <br /> MW-6 -i10 b a 4water 5 1 1 3 <br /> MW-7 b %u% water 5 1 1 3 <br /> Field Blank water <br /> TriBlank water 2 2 <br /> RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUHtEMENTS X 1. Routine Report <br /> Signatu Signature Signatu I Signa 24 hr _49>a _5day IL Report(includes DUP,MS <br /> X surdard(-10-15 ao"Sdgn) MSD,as required,may be <br /> Prin Printed Name Printed Name Print Nam Provwo vernal Preliminary amus charged as samples) <br /> b 1 < Q ProvMo FAX Pe m neryRoWu III.Data Validation Report <br /> Fum �s FirmFirmFid Rapostd Report Date: (includes All Raw Data) <br /> %,, IX RWQCB <br /> Datdriime -gyp Daterime Date/Time Date/15me + (MDLAIPQLS/TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instruetions/Corr nts: Container Types Key: <br /> Columbia Analytical 40 ml VOA: I <br /> Signature Signature Please report MDIs,PQLs,and Trace. 2655 Park Center Drive,Suite A 250 nil LPE: 2 <br /> Nitrate Nitrogen has a 48-hr hold thee. Simi Valley,Calif 93065 500 ml L.PE: 3 <br /> Printed Name Printed Name 805-526-7161/Px:805.526-7270 1 liter HDPE: 4 <br /> Firm Firm ContactKam Ryan 500 ml glass: 5 <br /> 1 liter glass: 6 <br /> EDDs to<susan.waterr=@shawgrp.com> UPS ship acct:9653EI 2x6 s/s ring: 7 <br /> DatuMme Datel'i5me <br /> glassjar 8 <br />