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California Water Labs, Inc. <br /> P.O. BOX 4249 _ <br /> 1430 CARPENTER LANE—SUITEG <br /> MODESTO,CA 95352 <br /> PHONE(209)527-4050 <br /> S <br /> CHAIN OF CUSTODY RECORD v <br /> PROJECT NAME: <br /> De G �B <br /> .j <br /> SAMPLERS (signature) L Number V''i \ ~ <br /> REMARKS <br /> of 9� <br /> Station Con- <br /> NumberDate Time ? Station Location tainers <br /> u c� <br /> 6 woo x D tier e e 3 EPf} X41 6 Z <br /> T+ <br /> r <br /> Rel ed by(stur Date / Time Received by (signature): Relinquished by(signature): 'Date / Time Received by (signature): <br /> '7�7 KJ �U <br /> Compan or Ag cy: Company or Agency: Company or Agency: Company or Agency: <br /> Gv v� <br /> Relinquisheg by{sipaturg): Date / Time Received by (signaturf): Relinquished by: Date / Time Received by (signature): <br /> Company or Agency:. ��• tj, Company or Agency: ' Company or Agency: Company or Agency: <br /> Relinquished by(signa ure): Date / Time Received for Laboratory by: Date / Time Remarks/Shipping Information <br /> (s nature) 6 <br /> Company or Age y:- C/��- 6 1? / � <br /> � <br /> 1 ( �Liu LAY �� <br />