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a <br /> e <br /> m <br /> > ;v <br /> .. y <br /> CTI <br /> co N ace j3Q c1 ► Form 3 cb <br /> z � <br /> ANALYTICAL SERVICES 4100 Atlas Ct.-Bakersfield,CA 93308-661.327.4911-Fax:661.327.1916-www.pacelabs.com y <br /> R"W'� Arcadis U.S. Inc proect#:30274343.01 - �801897 of <br /> 4 Client: t E <br /> o Attn:Dalia Rumani Protect Name:Forward Landfill o Y _ Comments: Z <br /> I- m E e Also send results to Zina Kamal(Zina.Kamal@arcadis.com), CL m (� <br /> 0 0 Street Address: 18401 Von Karman Ave,Unit 300 131D# 1 Q26 Ex action Wells Z N Elena Strom(elena.strom@arcdis.com),and Kyle Power n N <br /> Sampler(s)Name r> o <br /> Dos city,State,Zip: Irvine, CA 92612 Printed: O H $ (kpower@trihydro.com) °o e <br /> O k <br /> Z <br /> e Phone:805.234.1390 Fax: t <br /> ° email: dalia.rumani@arcadis.com p Sample Matrix Result Request -Surcharge CD <br /> p c� N a o x(eTD !-,5 Day.. �4 Day.. N <br /> Work Order#: L 6 U I a , °' m <br /> v s a m d > - ; r3Da 2Da 1Da <br /> CID ° - o a o y - m =_ d Rush requests must be approved TI <br /> N O N = c N O <br /> m' e. a c> c� o > o Notes <br /> �i ni o` a 3 Other <br /> a a <br /> D4 U p <br /> W-7 21 k o <br /> a <br /> owo _ ^ co <br /> rn< s <br /> w G x <br /> C1 <br /> 0 <br /> v c � U3 <br /> O <br /> o h <br /> a, <br /> X1�1� <br /> J r — � .J Hu lIFVt <br /> t�\6 <br /> up2 / <br /> W n <br /> o DC C12 BQQ ABAS COT <br /> Co <br /> EL <br /> ID <br /> :v <br /> G � I <br /> m • EDF Re ulred Geotracker Global ID <br /> � ® Same as above ❑X Yes ❑No <br /> Client: Forward Landfill <br /> O d o- 1.Roll is d By D to Time 1.Received By Date Time <br /> Address:9999 S. Austin Road ----------------- 1 U 5-2ep <br /> 0 2. nquished By Date Time 2. By Date TIM <br /> ° city: Manteca State CA zip 95336 System# <br /> g (Needed for CUP) <br /> ° Attn: o Cordero-209-235-9622 <br /> o GISIKey❑Well Star❑ 3.Relinquished By Date T1me 3.Received By Date Time <br /> P.O.#: <br /> Pace Analytical Bakersfield does not accept samples containing radioactive material above background levels. Samples containing radioactive material must be disclosed prior to receipt.Any samples suspected <br /> ? of containing radioactive material above background levels will not be accepted and will be returned to client. <br /> o' <br /> 91 <br /> (D <br /> co <br /> O_ <br /> co <br />