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ENVIRONMENTAL Quarterly CHAIN OF CUSTODY <br /> www.fglinc.com Laboratory Copy (1 of 3) <br /> 111111111 Hill 11111 IMEW11111 1111111111111 33273:11!0212011 TEST DESCRIPTION - See Reverse side for Container.Preservative and Sampling information <br /> Client: Masco Family Olive EnvironmenW <br /> Address: Attn:Amanda Devlin <br /> 17950 Via Nicolo ;a <br /> Tracy,CA 95377 <br /> Phone: (209)8364600 Fax: (209)836-0853 3 c <br /> Contact Person: Amanda Devlin <br /> Project Name: 3S Q o0 y <br /> Leach Line Monitoring <br /> Purchase Omer Number: to R Q <br /> Quote Number: °D <br /> a <br /> Sampler(s) P�(vv4PI{1 LA <br /> Ha z M <br /> • aOa 0 N� <br /> Sampling Fee: Pickup Fee: r 7`� O A 6 12.9 <br /> x a <br /> Compositor Setup Date:`!`I_ Time:_I_ z O Z L ¢N x <br /> Lab Number: STK 3-11544 o c yds o q.. <br /> amp Date Time c� ..v 5 E 14 t3= <br /> Num Location Description Sampled Sampled 1 d° od O X0 n 3 q c <br /> 1 LA 321_77 G WW 1 1,1,1,1 2 <br /> 2 L-2 3_ Y G WIN 1 1,1,1,1 2 <br /> 3 L-3 _ I'C,X G WW 04 1 1,1,1,) 2 <br /> Remarks: Relinquished Date: Time: lin fished Date: Time: quished Date: Time: <br /> .� <br /> r�C{ 3`�f- I� II H� 1L /°` ��JaZ 170 <br /> :�cd By: Date: Time: By: Date: Time: Received By: Date: Time: <br /> �! ru-e�`��i 17d d <br /> Comorate Offices&Laboratory Office&h0i9fitory Office&Laboratory / <br /> 853 Corporation Street 2500 Stagecoach Road 563 E.LindoAvenue 3442 Em pj Vis ia,Calf is <br /> Santa Paula,CA 93050 Stockton,CA 95215 Chico,CA 95926 San Luis U E I <br /> c <br /> TEL:605/392.2000 TEL:209/942-0182 TEL:5301343-5818 TEL:805 78 491 P l <br /> FAX:8051525-4172 FAX:2091942-0423 FAX,5301343-3807 FAX:805 <br />