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CHAIN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM Page_of_ <br /> fR �l 4L 1( P.O.No: Direct Bill to the County 3 <br /> E. <br /> haw® 180 Promenade Circle Suite 320 5ricramento Ca 95834 Lab: BC Lobs Bnitersfeld <br /> 6 a <br /> y <br /> Project None: Harney Lane LF,San Joaquin County Anal sis.Re uested 3 k <br /> 3rd Qtr 2012. Ground Water d 3 <br /> Project Number: 139866 '< m <br /> Report to: Sheila Richgels,Shaw Environmental <br /> S <sheiln.rich gels@shawgrp.com> 916-5654327 I CL -t <br /> s a CC Report to: Jody Rhoades,Shaw Environmental c 0 <br /> oy q 965-d3G2 sfl <br /> > 6 <br /> Sampler's Signature: 6 ' <br /> dC 0 <br /> _I L-1 00a o O o REMARKS �. <br /> a sample 2012 LAB (Sample <'` <' VOAs L.LPE 250.1 500 LPE Container Types <br /> I.D. Date /Time J.D. (Matrix Ila NP 1.12904 HNO3 preservations C M <br /> ' a <br /> MW-1 -JC7 ]] I water 6<.` 3 I 1 1 <br /> o-CL ro MW-2 7" !Q•3� water 6 3 <br /> n � <br /> D a <br /> mnN <br /> w g MW-4 - 730 i water 6 1 3 1 1 1 <br /> c.8 MW-5 _� 7.•30 Wilk water 6 3 1 I 1 � HK BY Di � 101 � <br /> 0) :3. MW-6 - 7-30 kVA I water 6 3 l 1 1 <br /> N" Field Blanit At '7,30 0""JIA water 2 ? - SU <br /> LEI <br /> @ Trip Blank 7.3PU NJ Pf water 2 2 <br /> ,a I 0 <br /> yn' RELINQUISHED tll' RECEIVED Dl' RELINQUI511ED DY RECEIVED DY TURNAROUND REPORT REQUIREMENTS Pd <br /> y� g I REQUIREMENTS X I. Routine Report <br /> Sign a Si TO Sinn ntur24 hr 481r _5day IL Report(includesDUP,MS <br /> Xswi _I d(-10-15 <br /> tearhin8 days) MSD,as required,cony be <br /> W <br /> v R Prin Numc Pri1 d Na Vi ted Name Printed ne Prar{de va'M Preaad—y aeasas charged as samples) <br /> / +SS N.,i&FAX N.Nl h-yft—lu 111.Data Validation Report <br /> 'a5 5 Firm Firrst�/' / ,,,. Firm Fig /L y/3 requested Repan Date: (includes All Raw Data) <br /> Slunylinvitonmenlal ''���7t/� I ��JY C_ 1T/� X RWQCD <br /> Dale/Time 700-1a 1 Dn1cMme7r ./2 I Dnlc/Time '3/'/ d Dntcrrime 7. _ (MDIs/p tsrMACC#) <br /> RELINQUISHED BY RECEIVED BY Specinl Instructions/Commentst <br /> t.t_ awv BC Labs-Tina Green <br /> g 19 > Sfgna aro ) nal Please report AIRL's,PQL's and Trncc. 4100 Atlas Court <br /> Bakersfield,Ca 93308 <br /> 4 Printd Namq ((.., led e I 661-327-49111 FX:327-1918 <br /> B c C � b %�onQ Ship via UPS Acct 965376 <br /> s � Finn Firm (� <br /> 1) EDDs to tsusan,walcrmnnQshovgrp.com> <br /> Daterrhue <br /> V�zl,. 1��t�, . _`� •3 �' lel aZ l'u f) p1y'-r <br /> a. <br /> 91. <br /> l <br /> 0 <br /> � F <br /> a7 <br /> m <br /> m <br /> W <br /> A <br /> 0 <br />