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�Q. <br /> General COC MAI Work Order# -/ <br /> McCAMPBELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd.Pittsburg,Ca.94565-1701 Tum Around Time:l Day Rush 2 Day Rush 3 Day Rush I STD • Quote# <br /> �;;' Telephone:(877)252-9262/Fax.(925)252-9269 J-Flag1 MDL . ESL Cleanup Approved Dry Weight Bottle Order# <br /> www.mccampbell.com main(d n c.campbell.com Delivery Format. PDF I GcoTracker EDF EDD I Writc tin(DW) I Detect Summary' <br /> Report To: Kathy Hieb Bill To:See Below Analysis Requested <br /> Company:Caiifomia Department of Fish and Wildlife o a ^ <br /> Address:2109 Arch-Airport Rd. Suite 100. Stockton, CA 95206 3 3 = Q <br /> Email:kathy.hieb@wildlife.ca.gov Tele:209-234-3484Q <br /> s m o c e ^ 0 <br /> Project Name: Project#: _ O o �•r•� <br /> u ar Y. ar rA. d ? d _ \V <br /> Project Location: PO# ° + c ` 3 Q _ LC) <br /> Sampler Signature: 0. <br /> Y m c U e m z <br /> SAMPLE ID Sampling g -- m at _ r a o a y 00 <br /> 5 Matrix Preservative a o °d c v v o <br /> Location 1 Field Point o m <br /> - -; � a a e s z 'a Date Time U e e e nc- ¢ o, <br /> O w m r w � a� W_v �- <br /> Tank A (3,000 gallon tank) liquid • <br /> MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause immediate hart or serious future health endangerment as a result of brief,gloved,open air,sample handling by MAI staff <br /> Non-disclosure incurs an immediate 3250 surcharge and the client is subject to full legal liability for harm suffered.Thank you for your understanding and for allowing as to work safely. <br /> •If metals are requested for water samples and the water type(Matrix)is not specified on the chain of custody,MAI will default to metals by E200.8. Comments 1 Instructions <br /> Please provide an adequate volume of sample_If the volume is not sufficient for a MS/MSD a LCSILCSD will be prepared in its place and noted in the report. <br /> Relinquished By 1 Company Name Date Time Received By I Company Name Date Time <br /> s ,� 11 3 <br /> Matrix Code:DW=Drinldng Water,GW=Ground Water,WW=Waste Water,SW=Seawater,S Soil,SL=S1u e, Air,WP=Wipe,O=Outer <br /> Preservative Code: 1=4°C 2=HCl 3=H,SO4 4=HNO3 5=NaOH 6=ZnOAc/NaOH 7=None Temp oC Initials <br /> Page_lage-g of 9 <br />