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Billing Information: Analysis /Container / Preservative zhain of Custody Page of <br />UPRR - American Integrated Services, Inc UPRR Prey <br />Chk <br />/Or"? <br />' FlaceAnalytical* P.O. Box 92316 <br />long Beach, CA 90809 <br />WR# 002533 <br />Ronort try Email To: <br />Leah Brinson / (GHD) Rep Name I leah.brinson@ghd.com <br />12065 Lebanon Rd 0 .: .. 0 <br />Mount Juliet TN 371., • •- .. <br />Phone: 615-758.585F • <br />Project <br />Description: UPRR Stockton -HazMat 79020-117 In <br />City/State <br />Collected: Fremont <br />li <br />I phone: 800-757.585, A a .ax: 615158-5859 0 die <br />Phone: 317-291-7042 <br />Fax: <br />TClien! Prolert is <br />AIS - 79020-117 <br />tab Praiect # <br />WR# 002533/ Paul Holt <br />ow to a r. <br />s• <br />LB te.,1 -7,77-zoi <br />B 146 Tab <br />P.O.is Collected by (print): Site/Facility ID is 2 Acctnum:UPRRAMER <br />Collected by (signature): Rush? (Lab MUST Be Notified) Quote # kJ ..... <br />0 <br />in <br />t.) <br />Template: <br />Same Day X Fore Day " 0i .... Prelogin: <br />/.;• <br />Immediately <br />Packed on Ice N Y x <br /> Nest Day 5 Day (Rad Only) Date Results Needed <br />Two Day 10 Day lflad Only) <br />Three Day 0 of <br />No. <br />ve > <br />---- -- <br />0 %.0 I.- <br />a. <br />1— <br />-- In <br />c <br />o <br />CL <br />TSR: <br />PB: , <br />Cntrs ,04:1 ,ors'l ; = <br />.0 oti iv Shipped Via: <br />Sample ID Comp/Grab ` Matrix Depth Time ..-... --- a) <br />- . . 0. u. Rem. ks Samplf, It (lab only) <br />— <br />#1 Oily Debris I Rags / PPE Grab OT Grab volz-lito . --t 2_ -2— 2 X .X X X X <br />— <br />Matrix: Remarks: Sample Receiot Checklist <br />SS - Soil AIR - Air F - Filter (8015) TPH quantified in the following ranges with contingencies for 96 hour , Temp COC Seal Present/Intact: <br />GW - Groundwater B - Bioassay <br />WW - wastewater <br />fish bioassay if the following levels are observed:TPH oil a 10,000 mg/kg,TPH <br />man...a...It. .- gli Flow Other <br />COC Signed/Accurate: <br />Bottles arrive intact: .....f <br />---......di <br />eli <br />t Correct bottles used: <br />DW - Drinking Water <br />OT - <br />Samples rett#,A0 via: - . — - <br /># <br />k.i --) c-9 i ail 6 Sufficient volume sent: <br />If Anolicable Other UPS FedE), _Courier _ ATracking g VOA Zero Headspace: Y N <br />Relinquished by : (Signature) -1. Date: Time: Recei by: (Signature) Trip Blank Received: Yes / No <br />HCL / MeoH <br />Preservation Correct/Checked: --Y --N <br />I 5-24 ;,V4e,g" <br />TBR <br />Reli ed by : (Signature <br />_Z <br />Date: Time: <br />I litZ 9' <br />eceived by: (Signature)r v T . . , c Bottles Received: <br />---- nioi —,.._......-__..... <br />If preservation required by Login: Date/Time <br />,4 70 <br />Relinquished by : (Signature) Da e: Time: Received for lab by: (Signature) . <br />/ <br />---, • c-iit, "4.- <br />Date: Time: <br />4; .c-) 'I-74 <br />Hold' Conditi <br />NCF /