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I null' GROWERS LABORATORY, INC. CHAIN-OF-CUSTODY <br />Date: Type of Sample: Composite(C) Grab (6) INumber of Containers Type of Containers: (B)Brass (V) VOA (G) Glass (P) Plastic [(P) Potable (NP) None Potable Preservative:NaHSO4, HU., H2504. HNO3, pH <2 NaOH pH> 9 or p11>12 ; Na2S203 if chlorinated Other Sample Condition: Temperature (1) Leaking. (B) Broken (HS) VOA Headspace _Custody Seal (Y) (N) a <br />g <br />a.- -0 = 7, <br />7.; <br />....I'm <br />— i. (SW) Surface Water MW) Monitoring Well (GW) Ground Water TB) Travel Blank (WW) Wastewater 5) Spike 0141 Drinking Water 1 C. <br />Q <br />LCD <br />, <br />Client: P1151/ <br />Phone: (9-51 <br />Fax: ( <br />Address: <br />`billi\) 9E52.0 I <br />)41(06 -035- <br />WI ) -41-1A-- O US E. <br />Project <br />Contact <br />Sampler(s): <br />comp sampler <br />Time: <br />name: V4Arg—LtXPia 62-0:NP6g...c leS <br />person: OA . 04.01-ys <br />Vlifftra-`e aleVreS <br />setup:Date: / / Time: : <br />Mileage: <br />Purchase <br />QA/OC report <br />Lab number: <br />order nu mber: <br />required: Yes .'/'- No <br />ZIligi: Location/Description LI:Pled II:Pled <br />51931 93W/Pra2 Le-0 5-14---ct 3 9:zAiiik t- V '1.1A1 (f lu.. <br />, . <br />, <br />_.. <br />. . _ <br />_ <br />_ <br />Rush results <br />Final sample <br />Lab disposal: <br />Meth. of <br />Misc. notes:. - <br />r•--i \ <br />disposition: <br />Return <br />(2,2 Liu ,e-e--S Relinquished by: Date: Time: <br />/1(13 (a,29- <br />Received by: Date: 2- <br />00J-u„,,,_ osh51(53 /o_free5(10 <br />to Client: <br />ret.: <br />due by: ci„ <br />disp.: Date of / / <br />C erk2fete_021i ll UM( <br />P 0 Box 272 853 Corporation Street <br />Santa Paula, CA 93061-0272 <br />TEL: (805) 659-0910 <br />FAX (A0s) s25-4177 <br />4111Ceillaboriltell <br />2500 Stagecoach Road <br />Stockton, CA 95215 <br />TEL: (209) 942-0181 <br />FAX (209) 942-0423 <br />Eielc1_0t1ica <br />Visalia, California <br />TEL: (209) 734 -9473 <br />Mobile: (209) 738-6273