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1046 Olive Drive,Suite 3 916 753 9500 CHAIN-OF-CUSTODY RECORD AND ANALYSIS REQUEST <br /> Western Environmental Davis, CA 95616 FAX# 916-753 6091 <br /> Science 6 Technology LAB# 916 757 4650 <br /> Project Manager phone# ANALYSIS REQUEST TAT <br /> W E T i•-1 <br /> Company/Address FAX# <br /> TOTAL(e) <br /> Project Number P 0 # Project Name m v �_ ° <br /> N w Y <br /> Z c m O N <br /> a LU C:) <br /> in <br /> Project Location Sampler Signature o LO m N y v <br /> o N U y > N <br /> S-�-o t k- �r 72 �' Ar7 <br /> o co v m �p Cn N W oc tX <br /> m -- °n ro m d a C] O w p r z U W W <br /> G 0 ° i 0 a o a N u� cn <br /> Sampling Containerrix o �, ;, Q N m 0 o w h N > 0Sample P 9 az v � oe � � mm ommU � ^ ONS UJw- a <br /> co co 'q 0Z a d <br /> ID DATE TIME � � � w w J X � Q 0 � z m c� � � m cNn CQ7 � � a p U � � Q <br /> UJ a 0 w a w w 2 a a a a a a a m a <br /> B o cn a p a a a 0. 0. fL m a a W v X <br /> p C7 a U z v O N y� F- rn www w W w ue 0 U w -i U a� w N <br /> cn - r z _ z3: ca IM <br /> o�2 -Vo Db 7- X <br /> X X <br /> i <br /> Relinquish d by Date Time Received by Remarks <br /> TAT- 1 <br /> �3 �•3U '' <br /> Re/linquished by Date Time Received by „ 1"POEIV <br /> REC . <br /> V Lz�o I <br /> dst 1 l <br /> fielindukshed by at Time Rec �6y-6a tory / BIIE To datcl� ` <br />