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CHAIN OF CUSTODY/ LABO RY ANALYSIS REQUEST FORM Page,_ <br /> P.O.No: Direct Bill to the County <br /> SH4!aW" 180 Promenade Circle Suite 320 Sacramento Ca 95834 Lab: BC Labs,Bakersfield <br /> Project Name: Harney Lane LF,San Joaquin County Analysis Requested <br /> 2012 Surface Water <br /> Project Number: 139866 <br /> Report to: Sheila Richgels,Shaw Environmental <br /> <sheila.richgels@shawgrp.com> 916-565-4327 <br /> CC Report to: Jody Rhoades,Shaw Environmental o <br /> <jody.rhoades@shawgrp.com> 916-565-4362 w <br /> 0 0 <br /> Sampler's Signature: <br /> o Q <br /> w U ° REMARKS <br /> Sample 2012 LAB Sample VOAs L.LPE 250 ml 500 Container Types <br /> I.D. Date Time I.D. Matrix HCl NP H2SO4 O Preservations <br /> S-1 water 6 3 1 <br /> S-2 water 6 3 1 1 <br /> RELINQUISHED BY RECEIVE Y RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X I. Routine Report <br /> Signature Si ature Signature Signature 24 hr 48 hr 5 day II. Report(includes DUP,MS <br /> X Standard(-10-15 working days) MSD,as required,may be <br /> Printed 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 Finn Firm Requested Report Date: (includes All Raw Data) <br /> Shaw Environmental X RWQCB <br /> Date/Time Date/Time Date/Time Date/Time (MDLs/PQLs/TRACE#) <br /> RELINQUISHED BY RECEIVED BY Special Instructions/Comments: <br /> BC Labs-Tina Green <br /> Signature Signature Please report MRL's,PQL's and Trace. 4100 Atlas Court <br /> Bakersfield,Ca 93308 <br /> Printed Name Printed Name 661-3274911/Fx:327-1918 <br /> Ship via UPS Acct 965376 <br /> Firm Firm <br /> EDDs to<susan.waterman©shawgrp.com> <br /> Date/Time Date/Time <br />