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TEG Noll *California Inc Chain of Cu; Record <br /> 11350 Monier Park Place Ph 916 853 8010 Page of <br /> Rancho Cordova, CA 95742 Fax 916 853 8020 <br /> Client loos F v►vwyn n&,44 t, Project Manager sk,,t Wow j.,u!/ E-Mail (e�Is"", ,d s ,,,"Ot, cv <br /> Address _)y'? N. 3rd ,¢�,Q TEG Project# 0 .- Client Project# <br /> phoe",-A� n7 85003 _ _ Location L,- I l -40q g-o C. 1, - r <br /> _ <br /> Phone boz_ _p Fax i6oz-37g-c4oIR Coltec#or � ,� mod 1,. li Date of Collection <br /> & <br /> 51 �em�1 oma <br /> `Lre, <br /> � `h G$, <br /> o <br /> Sample Container �a �o 9 o ��, ° <br /> Sam le Designation Date I Time Matrix Type AQP AQP AQP AQP AQP h�+� �Q� �Q� �QRX �� �' Field Notes ° <br /> x 'L- r t <br /> 1.3-SI <br /> DPS- 4o xY, x <br /> flPg- so - 2-7 <br /> DP8- too ,1 X Iw S { <br /> 9PS'-17L5 I 1 15.31, X x <br /> DP$-ISo I402 X ! T I <br /> R_ Iz5 3/8/06 16 2-1 14"-<5 3 J <br /> -S/,e/0G 17 03 <br /> E <br /> ReX_ �41—e;no" <br /> Date 1 Time fjzc ved b ! Date 1 Time <br /> �j Sample Receipt Remarks <br /> Relinquished by Date 1 Time W6ceived 'Date 1 Time Good Condition? <br /> Cold? <br /> Relinquished by Date 1 Time Received by Date 1 Time Seals Intact? <br /> Total number of Containers <br /> L)iYellow-Renn White-!a6 Yellow-Re Pink-bdginalar Sample disposal instructions , TEG disposal @$4 00 ea —Return to client —Pickup <br />