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UPRR- Patriot Environmental Services Billing Information: Analysis/Container/Preservative Chain of Custody Page_of_ <br /> 5025 Arnold Ave, Bldg 24, Ste 100 UPRR Project Manager: Chks <br /> McClellan, CA 95652 —Michael /�� <br /> rumntloAna ftaximrar.m <br /> Algots <br /> O <br /> Report to — Email To: --- hors tewnon Ra [oilT ■ <br /> Amy Moore amy.moore@patriotenvironmental.co :�. <br /> Pho Mount 157 8-3JIE2 <br /> Project City/State Pxo 615J59 585a <br /> Motor Oil Spill ColleRed:4/29/20 86 <br /> ooas sesa 0 <br /> Description: els�seseso ■ x a <br /> Phone:916-413-4058 Client Project# Lab Project# a L# <br /> Fax: Modesto,Ceres CA 11-20-00069 <br /> Tat D075 <br /> Collected by(print): Site/Facility ID It P.O.If n, <br /> Atctnum[U!0KHrm 1 <br /> Amy sore R#000234 - O �I <br /> M Template: <br /> Collected y(signature): Rush? (Lab MUST Be Notified) Quote# a W L p <br /> _Same Day _Five Day V N V 01 N Prelogin: <br /> Next Day _5 Day gad Only) Date Results Needed N t.J 0 = C O TSR: <br /> Immediately _Two Day _10 Day(Rad Only) No O 0 > O_ O M ' 7 <br /> Packed on Ice N_ Y� Three Day of b � 1AH D. _ O PB: <br /> L ! <br /> ntrs O n <br /> r– r m Shipped Via: <br /> Sample ID Comp/Grab Matrix' Depth Date Time O N N O I A = O tD V <br /> aema�: say- iesi,ao��isi i <br /> to to oro w LL._ a. � _._D` a _ <br /> Sample#1 Sand Comp SS 4/29/20 11;20 I X X X X X <br /> Sample#2 Sand Comp SS 4/29/20 11:30 I X X X X X - �Z <br /> I <br /> i I <br /> Sample#3 Motor Oil Comp OT 4/29/20 11:40 I X X X X X XX X - 0 <br /> Sample#4 Motor Oil Comp OT 4/29/20 11:50 X X X X X X X X e - 1 <br /> I <br /> Matrix: Remarks: Sample s <br /> SS-Soil AIR-Air F-Filter pH TempcoC Seal Present/Intact: P Y N <br /> GW-Groundwater B-Bioassay WR#000234. Run additional testing if near limits.3-DAY RUSH!!!! CDC signed/Accurate: 1Y _N <br /> WW-WasteWater _ Bottles arrive intact: <br /> FIOw Other Coareco bottles used: <br /> DW-Drinking Water Samples returned via: S.ffic_enc vulOme seat: h m <br /> OT-Other011e _UPS _FedEx _Courier _ Tracking It f Ad licabie <br /> VOA zero eeadY n <br /> Relinquished by:(Sign/ature) Date. Ti.,e. Rece'v r.IS'geatn,el Trip Blank Recei Yes No Preservaticn Correct/Checked: _Y _N <br /> ,/x'r4•Ti�/e�`7a(� !/ ' H eoH <br /> TBR <br /> Relin " hed by:(Signature) Date: Time: 'Received by:(Signature) Temp: Bottles eceived: If preservation required by Login:Date/Time <br /> einquished by:(Signature) Date: Time: Receiv rlab by' ignatur % V Date: Time; Hold: Conditio <br /> qA11 NCF / k, <br />