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Chain of Custody Record 0A -T- Page Sof_. <br /> URSFacility Name: Franks one stop On-site Time: �;v Temp: S/ <br /> Site Name: Franks one stop Off-site Time: )y O�D Temp: �5 <br /> Sky Conditions: <br /> for California RESD State or Lead Regulatory Agency: Meteorological Events: 04\A- <br /> Requested Due Date(mm/dd/yy): Standard TAT ind Speed: NS Direction: V4 V) <br /> Fan Curtis and Tompkins,Ltd Facility Address: 2072 west osemite avenue Consultant/Contractor: URS <br /> 23 Fifth Street Manteca, California Address: 2870 GatewayOaks Drive,Suite 300 <br /> erkley,CA 94710 Site Lat/Long: N/A Sacramento,CA 95833 <br /> nne Kathain California Global ID No.: N/A Consultant/Contractor Project No.: 17325996. <br /> ZZ <br /> 10.486.0900/ Enfos Project No.: N/A Con sultant/Contractor PM: Vernon Elarth <br /> act: Site Designation: FOS Tele/Fax: 916.679.2000/916.679.2900 <br /> Phase/VJBS: monitorin wells Re ort T e&QC Level: Level 2 with EDF/EDD <br /> Sub PhascvTask: Analytical E-mail EDD/EDF'Marcie Redmond urscor .com <br /> ask Code: 01004 Invoice to: URS <br /> Lab Bottle Order No: Matrix #containers w/preservative Requested Analysis <br /> c <br /> Item ESamplecri tion R ' rNo. p A v a Laboratory No. w oo T Sample Point LaULong and <br /> ro 4 ° y $ a a Comments <br /> Cj s c7 A <br /> o ] x x o a a <br /> 1 1-7-71-7 -6AC1 lyse NO <br /> 2 3b/ <br /> ,K _`H <br /> 3 lc�-f s¢e ►,Heir ,� <br /> 4 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Sampler'sName:—r A}N�/ ��� Relinquished By/Affifiation Date Time Accepted By/Affiliation Date Time <br /> Sam lei's Com an _S t t�cZ f' U YZ 3 <br /> Shipment Date: al-4t <br /> Shipment Method: 14 XN lj '11)OL kj Q.Lt; <br /> Shipment Tracking No: <br /> Special Instructions: P_UlA i2oli L1 L t,S P-X t V P7 A r-[ _zF c <br /> —4 k t r <br /> Q Custody Seals In Place Yes No Temp Blank Yes No Cooler Temperature on Receipt °F/C Trip Blank Yes No <br />