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E n s e c o " Page of <br /> CHAIN-OF-CUSTODY RECORD <br /> SAMPLER:(Signature) <br /> Date Shipped Carrier <br /> Phone Airbill No. Cooler No. <br /> SHIP TO: SEND RESULTS TO: <br /> Enseco-Cal Lab Client Name1JDE�Y�1� �f-o;rT&� (/ V' <br /> 2544 Industrial Blvd. Company <br /> West Sacramento, CA 95691 i Address <br /> (916) 372-1393 , flu 9.66 Z5 <br /> ATTENTION: Phone <br /> PROJECT NAME / "111 / (i� S T TL PROJECT NO. 7d?U- Z P.O.NO. <br /> Relinquished by;_(Signature) eceived by (Si a e) Date Time <br /> 411) <br /> Rylin ,ishe.d b3:'(Signature) Receive y: (Signature) Date Time <br /> R61inquished by: (Signature) / Received,at)Ab by: (Signature) Date Time <br /> Relinquished from lab by:(Signature) Received/by. (Signature)`� f Date Time <br /> ANALYSIS REQUEST <br /> Sample ID Sample Date/Time Sample Condition <br /> Number Description Sampled Analysis Requested Upon Receipt._. <br /> )11 u) #/ 3 �bl s z� b LX LIL 62u >/ <br /> Awl y0d ) <br /> Special Instructions/Comments: <br /> NOTE: UNUSED PORTIONS OF NON-AOUEOUS SAMPLES WILL BE RETURNED TO CLIENT <br /> Expected <br /> Analytical Immediate <br /> T.A.T's: Attention (200% surcharge) RUSH (60-100% surcharge) Standard <br /> Cal Lab ID Number: (for lab use only) <br /> 6 1// � YJ Client Retains White Copy Only (Revised 1/87) <br />