Laserfiche WebLink
n <br /> CHAIN OF CUSTODY/LABORATORY ANALYSIS REQUEST FORM Page_of, <br /> n 12—t ti t5 P.O.No: Direct Bill to the County 0 <br /> ay lJ <br /> 180 Promenade Circle,Suite 320,Sacramento,Calif 95831 Lab: BC Labs,Bakersfield nm <br /> Project Name: Harney Lane LF,San Joaquin County Analysis Re uested w 5. <br /> 1st Qtr 2012 Ground Water-Annual ; 03 <br /> s ProjectNumber: 139866 q 0 .0 3 <br /> lZ <br /> o Report to: Sheila Richgels,Shaw Environmental <br /> o <sheila.richgels@shawgrp.com> 916-565-4327 = 7 0 <br /> o a CC Report to: Jody Rhoades,Shaw;'environmental e y n <br /> °o <jody.rhoades@shawgrp.com> 6 565-4362 w o a ,fl ,1 <br /> > S ° a1 �' t V n m h. <br /> Sampler's Signature: a; x t0 <br /> o <br /> C) <br /> 3 a 3 d d o rip ° <br /> LQ U n V, _ U U `' H REMARKS a ►� <br /> W n 4 Sample 2012 LAB Sample voAS L.LPE 250 in[ 25010 Soo LPE Container Types <br /> a ; I_D. Date Time I.D, Matrix ncl NP tt2so4 xNoa NNo3 Preservations O f' <br /> MW-1 <br /> I-1� t2 a13 —4 water 7... 3 1 l 1 1 <br /> CD <br /> o MW-2 >r21 -L water 7 3 1 1 1 1 <br /> C) o MW_3 �pJb -3 water 7 3 i 1 1 I CHK B DISTRIBUTION <br /> co 12- <br /> ;z c ' <br /> w MW-4 913 —4 water 7 3 1 1 1 1 a � -- <br /> W �u -ouT w <br /> m g F MW-5 r�-�(" -5 water 7 3 1 l 1 1 --- a+ <br /> rn R M W-6 {A water 7 3 t 1 1 1 11 I-A D <br /> 2 2 <br /> Field Blank T" water sa <br /> S rn <br /> W A_ <br /> J a2 <br /> o <br /> Trip Blank + } water 2 2 <br /> BOD <br /> CD n z t -0 <br /> --n ° <br /> n moRELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREAIEN'TS N <br /> > c oREQUIREMENTS X 1. Routine Report <br /> c rotur Sig�rc Signature Signalure to hr _481,, _54.y 11. Report(includes DUP,MS <br /> aycg <br /> .�� X standud(-Io-IS wnrkingdaye) MSD,as required,may be <br /> N, <br /> o a Pr d Nnmc 1'r' d Name Prin d Nnme Printed Name l rrowuie v,,b.i Ndi.i—yn�,wa chnrged as samples) <br /> UC. >�1JC7/7J}1 X 1 S$ G SS ��G CMZ j5�(GGf}x✓ —Pr-i&raXrr,rnnaryar�Wu III.Data Validation Report <br /> Co o Finn Fir Fi I Fi /,9 n,gnesed n,pw 1) (includes All Rats Data) <br /> S Shmv Environmental / 3 �C X RWQCB <br /> Dntc/rimel-t f-1Z r7i Datc(fime Z Zti DntelTime q 2 b Datelrimc /-l9 /� /, D5 (MDLs/PQLs/TRACEt/) <br /> o RELINQUISHED BY RECEIVED BY Special instructions/Comments: Container Types Ivey: <br /> v w 1 BC Labs-Tina Green 40 mI VOA: I <br /> N P C Signature p� Si / Please report A1RL's,PQL's and Trace. 4100 Atlas Court 250 ml LPE: 2 <br /> 3 a j�A Nitrate-Nitrapri fins a 48-hr hold time. Boltersfield,Co 93308 500 ml LPE: 3 <br /> Z. <br /> Printed Name 7 Printed Norna 661-327-4911/Fx:327-1918 1 titer HDPE: 4 <br /> o IG,R �' n,,q,7✓ .� Cr•('C/ Ship vin UPS Acct 965376 500 ml glass: 5 <br /> c Fi ,n y e Fiprr„ BC Lab Courier: I liter glass: 6 <br /> C /�/ EDDs to<susan.tvatcrman@sharvgyp.eam> Ross Dickey @ 661-201-4171 2x6 s/s ring: 7 <br /> a <br /> -_ Dale(fime -/ �,} GC7 DalrMnic —` -Z- qw glass jar. 8 <br /> e <br /> Q <br /> 0 <br /> a <br /> m <br /> W <br /> ID0 <br /> ID <br />