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General COC MAI Work Order# �11 a1S/l og <br /> 7 McCAMPBELL ANALYTICAL, INC. <br /> CHAIN OF CUSTODY RECORD <br /> O 1534 Willow Pass Rd,Pittsburg,Ca,94565-1701 Tum Around Time:l Day Rush 12 Day Rush 1 13 Day Rush I I STDI I Quote#1 212878 <br /> Telephone:(877)252-9262/Fax:(925)252-9269 !-Flag I MDLJI Cleanup Approved Dry Weigh[ Bottle Order# <br /> www.mccampbell.com main@mecampbell.com Delivery Format: PDF • Get,I rtcker EDF I EDD I I Write On(DW) I Dcicct Summary <br /> Report To:Paulette Cordoni Bill To:SAME Analysis Requested <br /> Company:Safety Kleen(SKS) r <br /> U <br /> Email:paulette.cordoni@safety-kleen.com _J H <br /> Alt Email:Kyle,Sewell@safety-kleen.com Tele: 460.403.1780 <br /> Project Name:O'Reilly#2567 BRAKE LATHE SHAVINGS Project#: OR14384 t r r <br /> Project Location:1440 E Harding Way Stockton,CA 95205 PO# Q Q <br /> Sampler Signature: U U <br /> 0 0 <br /> SAMPLE ID <br /> Sampling 0 0 <br /> Location/Field Point a Matrix Preservative <br /> Date Time a U) CO <br /> BRAKE LATHE SHAVINGS 6115 12:00 OTHER NIA • • • <br /> MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may eause immediate harm or serious future health endangerment as a result of brief,gloved,open air,sample handling by MAI star[ <br /> Non-disclosure incurs an immediate 5230 surcharge and the client is subject to full legal liability for harm suffered.Thank you for your understanding and for agowing us to work safely. <br /> -If metals are requested for water samples and the.vater type(Matrix)is not specified on the chain of custody,MAI will default[o metals by E200.8. Comments/Instructions <br /> Please provide nn adequate volume of sample.If the volume is not sufficient for a MS/MSD a LCS/LCSD will be prepared in its place and noted in the report. <br /> Relinquished By/Company Name Dale Time 4eceived By/Company Name pate Time <br /> DIP 124 1 <br /> adz Uz± <br /> Matrix Code:DW=Drinking Water,GW=Ground Water,WW=Waste Watcr,SW=Seawater,S—Soil,SL Sludge,A=Air,WP=Wipe,O=Other <br /> Preservative Code: 1=4°C 2=HC1 3=H2SO4 4=HNO3 5=NaOH 6=ZnOAc NaOH 7=None Temp I °C Initials <br /> �fi f <br /> PagePage qA of 15 <br />