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Page—of_ <br /> CHAIN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM <br /> P.O. Direct bill to San Joaquin County <br /> ShQ_ <br /> 5 180 Promenade Circle Suite 320,Snernmento,Ca 95834 15 Lab: [3C Labs,Bakersfield -p'+ <br /> s' <br /> Pro jectName:Corral Hollow LF,San Joaquin County Anal sis Requested y <br /> tst Qtr 2013 Ground Water p <br /> y <br /> Project Number: 139881 ,C m <br /> x g Report to: Sheila Rieligeis,Show Environmental <br /> slleilo.riellgels@sltttrvgrp.com> 916-565-4327 .5 oo <br /> A CC Report to: Jody Rhoades,Shaw Environmental (� o <br /> v <br /> v x 9 <br /> o % <jody.rbondes a@shawgrp.com> 916-565-4362 41 S <br /> r <br /> C (D <br /> Sampler's Signature: 4r" —oma a w REMARKS m <br /> [ m U W z <br /> 3somi vons somal CuntainetT es <br /> w g Snmple 2013 LAB Sample LLPE )'p <br /> I.D. Date Time I.D. Matrix Nr rtr ttci F+raos Prescrvagons -ng. MW-4 .13 \5!5 water 6 1 1 3 1 j (-HK RY DIST-1113 )TIONF. <br /> 3 <br /> aK to <br /> n CL o MW-5 ® water 6 1 1 3 1 0 <br /> - SB-I t, � water 6 1 1 3 1 S U <br /> w <br /> w MW-6 �� water 6 1 1 300 <br /> ] <br /> co o Re MW-7 1`13 tivater 6 1 1 3 I <br /> s <br /> SHORT H T1ME <br /> rn A s <br /> _ MW-8 t®� water 6 1 1 3 1 r Nz s OP SS - <br /> w 5 MW-9 �y1p water 1 6 1 1 3 1 M <br /> 5 _ cc <br /> BOD R COT <br /> 'L ° MW-10 ` water 6 1 3 1 <br /> o o ` MW-1 l t�t3 voter 6 I 1 1 3 1 <br /> - <br /> a � w <br /> (t) Field Blank N1A water 2 2 <br /> Trip Blanl( i water 2 1 2 <br /> RELINQUISHED BY 11GCEIVED BY RELINQUISHED BS' RECEIVED 13Y TURNAROUND REPORT REQUIREMENTS <br /> nwi o RCQUIRENIENTS X 1. RoutincReport <br /> fi Lre Si is br .ta tR 5 Jay II. Report(includes DUP,MS <br /> Signnture Sig7 al�1re (� 8, At <br /> gn e P <br /> to a Q, l f:J,LGCv ��' �''a'^J fi 5modnrd(-,n-is,.erkieydnysl MSD,its required,may be <br /> 4 <br /> Printed N m Pria d Nmna Pr l Name Printed Namc ProdJu\'crbel I'rellminnq 0.aenhs charged as samples) <br /> o o Lv�n� �(� �CG G fL`� 1C.-,4-A) Pm�ilt,rax rremlann y Raoas Ill.Data Validation IUcporl <br /> o Firm Firm Firm �edn�onnr�: des All Rmr Data) <br /> o §bmiv Environmental �3CLb XRWQC <br /> l9atelPimc Q Dalcffime Daterrimc/ �j sd Dmc([ime /—� •/ 1 7 Uv (MDts/PQLsl1'RACBi!) <br /> ELINQUI IED BY RCCEIVLD BY Special bts(ructimtstEo 2nso Container Types Key: <br /> 3u, t+v5 Please report i1IDLs,PQLs,and Trace. BC Labs-Tina Green 40 rat VOA: 1 <br /> b Signature Signuwro 4100 Atlas Court 250 ml LPE: 2 <br /> 13 Nitrate Nitrogen lips a 48-hr BOLD TIME. Bakcrslleld,Cu 93308 500 ml LPE: 3 <br /> a <br /> ° Printed Name Printed Name 661-327,1911/Fx:327-1919 lMer HDPE: 4 <br /> C Incl m,p-xylene&a-xylene In 8260 results. Ship vin UPS Ace(965376 500 ml glass: 5 <br /> ' <br /> Firm BC Lob Courier: I liter glass: 6 <br /> � Firm <br /> Ross Diclwy rt 661-201-4171 20 sh ring: 7 <br /> Dnleffimc Dntc(rimc 1• r D <br /> lass Inr: 9 <br /> �`� ��-�.. l •a�-►� �� !�s �j-aR.'r;,����� �-�•�3 2125 het,, <br /> M P <br /> al <br /> M <br /> (D <br /> w <br /> o_ <br /> Vt <br /> W <br />