01.09.2013 Views

RECEIVED RX929!

RECEIVED RX929!

RECEIVED RX929!

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

FR-Central Plateau<br />

200-PW-2/200-PW -4 OU - Boreho le Soil Sampl<br />

lee Cheat No. ef^ C p<br />

Shipped To /'F ^l K^'^<br />

C).5<br />

POSSIBLE SAMPLE HAZARDS/REMAMI<br />

I Special Handling and/or Storage<br />

OF POSSESSION<br />

By/Removed From<br />

SAMPLE ANALYSIS<br />

Datdfime<br />

07<br />

Daldfime<br />

CHAIN OF CUSTODY/SAMPLE ANALYSIS<br />

Company Contact Telephone No.<br />

LC Hillstrom 373-3928<br />

Sampling Location<br />

216-A-37 (C4 106); ( 1 7.5-20')<br />

Fie Id Logbook No.<br />

HNF-N-3361 II7504FS10 OA<br />

Offsite Proper ty No. ^'J7 ZZ C)<br />

I P* 372<br />

By/Shed In<br />

Preserva tion<br />

Type of Container<br />

No. of Contsiuer(s)<br />

Volume<br />

Sample No. Matrix Sample Date Sample Time<br />

SOIL /t- (0<br />

Date rime<br />

ZS OS (6 YS<br />

SPECIAL INSTRUCTIONS 9 f(/2 bra f Matrix<br />

report both kerosene and diesel range compolmd3 f rom WTPH-D analysis.<br />

Datdfime<br />

S 103 1/0 C)<br />

Datdrime<br />

L>n^^_ ~tizsz— ,^f^c `^ILy^°)<br />

Datdrime<br />

Of<br />

Date/Tina,<br />

Datdrime<br />

Cad 4C I Cod

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!