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General COC <br /> MAI Work Order# lqa��T; <br /> ® McCAMPBELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Rd.Pittsburg,Ca.94565-l 701 Turn Around Time:l Day Rush 2 Day Rush �3Dayltush STD 'Y Quote# <br /> Telephone:(877)252-9262/Fax:(925)252-9269 I-Flag1.MDL ESCleanup ApprovedDry Weight Bottle Order# <br /> ww.mccanl bell.com maipQrr cearrtDbell.com Delivery format-. PDF G.Tracker EDF EDD Wr <br /> w ite On(DNV)l I Detect Sutmnary <br /> Report To: Tbv' PAC' }a✓l Bill To: •Tn Analysis Requested <br /> Company: 8 SK 4s3ae,-4a.3 <br /> Finail: 7.v,n{1 n e bsKe sstic�� s.cc;m `� <br /> Alt Email: Tele: <br /> Project Name: 94vc-Kk,,n A, K.1 PF-H s Project#: E2�1 6a/F 1 <br /> 0 <br /> Project Location: C-A PO# �2�i�`./G. cx cl•O+]� <br /> Sampler Signature: / IE <br /> m <br /> SAMPLE ID Sampling SAMPLE <br /> Matrix Preservative C <br /> Location/Field Point Date Time <br /> l3 -3� I ' , ► J� 11 z s S Nph� <br /> Ci- 3.3T el� 1r 3a � NvhQ x <br /> 3- 30 e- fs t 11 3S 5 1"'une <br /> 13- 3 C Z" ' <br /> F3 V e 30 1 5 5 S lira a� <br /> 3 s t <br /> MAI clients MUST disclose any dangerous chemicals known to be present in their submitted samples in concentrations that may cause irttmediait harm or serious future health endangerment as a result of brief,gluvcd,open air,sample handling by MAI staff: <br /> Nan-diseto5ure incurs an immediate S250 surcharge and the client is subject to full legal liability for harm suffered.Thank you For your understanding and for allowing us to work safely. <br /> 'If metals are tequesied for water samples and the water type(Matrix)is not specified on the chain of custody,MAI will default to metals by E200.8. Comments/Instructions <br /> Please provide an adequate volume of sample.if the volume is not sufficient for a MSIMSD a LCS/LCSD will be prepared in its place and noted in the report. (_")S'.e <br /> nRelinquished By I Company Name Date Time Received By 1 Company Name Date Time <br /> / l'�1�, r�5sc� .�, r � fz�' <br /> -� <br /> Matrix Code:DW=Drinking Water,GW=Ground Water,WW=Waste Water,SW=Seawater,S=Soil, -Sludge,A=Air,WP=Wipe,O-Other <br /> Preservative Cod : 1=4°C 2=HCI 3-1-12SOa 4=HNO3 5=NaOH 6=ZnOAefNa013, 7=None Temp aC Initials <br /> I � SckMVjt Tn mo-4-s ?.c r S qrn pw- CMj4imrS .�A <br /> Page of 3 <br /> Page 73 of 75 <br />