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'4080 PIKE-LANE,SUITE C CHAIN-OF-CUSTODY RECORD <br /> 1GTEL CONC 85-7,52 sa52o AND ANALYSIS REQUEST 35211 <br /> (510)685-7852 IAIOfAIO1111 IMC (800)423-7143 . t <br /> ampany Name: Phone 5-10 _ 737—7l ZO <br /> FAX It: So -9� �3 ❑ ❑ � o I <br /> Company Addr9ss: Site Location: m m ❑ ❑ <br /> IgYD X11, C„r(tOrvi, SOQ ❑ ❑Cfi _ ❑ m — cl: <br /> Ut°i7r ! n ID <br /> '9 C3N u a 11 ❑ ❑ <br /> Protect onager: Client Project I0: ( ❑ m ❑ a N <br /> ❑ ❑ m rn ur i a r Q u <br /> �A� I m d ❑ p ❑ z z L7 ❑ ❑ <br /> I attest that the proper field sampling Sampler Name(Print): a Q o p O o v E 5 v ❑ <br /> procedures were used during the 5 Q " ' N C1 C3 < ❑ n p a° <br /> collection of these samples. ❑ a N a N a <br /> ❑ u m <br /> qi v r a a ❑ n r <br /> Method o - = m m a m m m m Q U o 0 <br /> N Matrix Sampling m I a a m ❑ ❑ w as a o ❑ ❑ N ❑ a` ❑ <br /> Preserved N _ ❑ ti w w a a m o ❑ N <br /> Field GTEL w ❑ = c = Q m N <br /> Z o d caro a m p <br /> SamSample Lab# F t? ca a a N N ❑ <br /> p w u o ri ry m o X 2 m 1 <br /> ID {/Lab Use o f ❑ ❑o w � w Lu w m = m a a a a a a ¢ g a ° <br /> 1 Only. U a O ¢ F U Z w =i a F > – a ❑ a a a a a a a a U a a m `o <br /> 3 rn a W a o x z = v ah O_ o r- m m x x 'o F w w w w w w w w w r w v o` v <br /> COD2 yl 1010 x <br /> b Z Onb X <br /> co <br /> . <br /> d IZ�1 <br /> }� { <br /> Trip <br /> r <br /> TAT Special Handting SPECIAL DETECTION LIMITS f REMARKS: i I pp� �j PU ut �7� �'�a�fjc�K s _ <br /> Priority(24 hr) ❑ GTEL Contact 10&Ue rr ve't Prfter'� M<t ``}'t `�►� 1? 1 �Jl <br /> Expedited(48 hr) ❑ Quote/Contract# hp�yly/d t'� tree/ –P °°1I/�C fi P�y ° <br /> 7 Business Days O Confirmation# L r J.-rke' S�Jlts!! 70! t�^5T� � C <br /> Other <br /> Business Days ❑ P.O.# SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot#: Storage location <br /> OA/GC Level <br /> Blue f_"} CLP F Other❑ 1 FAX©, 1 Work Order#: <br /> Relinquished by Date Time Receive y: <br /> 7- 2 <br /> CUSTODY g .� � � <br /> Relinquished by: D to Time Received b : <br /> RECORD - r' <br /> Relinquished by: D t Time Received by L;boratory: <br /> Z (lf:l(1 <br /> Waybill q".—%lr�l <br /> I <br />