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General COC MAI Work Order 4 <br /> <br /> <br />ANALYTICAL, INC. <br />Pass Rd. Pittsburg. Ca. 94565-1701 <br />(877) 252-9262 / Fax: (925) 252-9269 <br />mainOmccampbell.com <br />2 Day Rush <br />( <br />CHAIN OF CUSTODY RECORD 0 McCAMPBELL <br />1534 Willow 1111-11 A1-01111t1 11111e: 1 Da% IZI1S11 STD • <br />Telephone: <br />Quote # <br /> J-i MDI. ITh li IS[ Cleanup Appro‘ed 3 D'I.. f)r":1.1 \1'ciii\ite Order 4 <br />www.mccampbell.com Deliver l'onnat: PUP (icon acker 1'1)1' H A ) <br />lr,tr (Boivt,)tle. \ on m <br />DetLet Summary <br />Report To: Daniel Kramer Bill To: Daniel Kramer A ialysis Requested <br />Company: Petralogix Engineering DBCP (E524.3) ----, <br />- <br />o <br />o <br />co <br />Z <br />--V <br />''.---- <br />Email: dkramer@petralogix.com <br />Alt Email: tscheftner@petralogix.com Tele: 209-400-5729 <br />Project Name: NLS/SSS Project #: Project <br />Project Location: 11655 S Union Road PO II <br />Sampler Signature:-7; 5e_lo.-6111A c47- <br />SAMPLE ID <br />Location / Field Point <br />Sampling := <br />- Matrix l'reserx alive <br />Date I hue <br />Geme6446-44e14— Duo 314_1;,\ al oa 5 1) (.....3 X <br />MM clients MUST disclose any dangerous chemical, known to be present in their .ubmith.d samples in concentrations that may cause in mediate harm or seri ins Illik re heal h enda rgerment as a emit of brief, cloyed open air, sample handlin g b , MAI st a ff <br />Non-disclosure incurs an immediate S250 surcharge : rid the client is subject to full legal liability for harm suffered. Thank you for your understanding and for t ;lowing us to work safely. <br />* If metals are requested Iiir water samples and the water is (Matrix) is not specified on the chain of custody. MAI will default to metals by F.200.8. Comments i Instructions <br />k , <br />Please provide an adequate volume of sample. lithe volume is trot sufficic it Ibr a MS/MSD a 1.CS/LCSD will be prepared it 4 p ll d noted 'n the report. <br />Relinquished By I Company attic Date , 1 line • v Bye Co Ilpi 1 Nall1C pate Tune <br />n i, Q:40k_ 3/LIP ) /L_L: /E7 Olik, • 2,,,4' 71_ 04 - <br />_._ <br />Matrix Code: DW-Drinking Water, GW=Ground Water. WW=Waste Water. SW=Seawater, S=Soil. SL=Sludge, A=Air, WP=Wipe. 0-0ther <br />Preservative Code: 1=4°C 2=HC1 3=1-12 SO4 4=1-1NO3 5=NaOH 6=Zn0Ac/Na01-1 7-None Temp <br /> <br />Initials .719 <br /> <br />AL-1- <br />Pa ge -Pageb of 10