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U!k c tia�r �ti <br /> o� SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton,CA 95202 <br /> . .. F ���e Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> �/FBre <br /> CHAIN OF CUSTODY RECORD G LA 0 <br /> 1. Sampler's Namett:Zq,p., Title Unit <br /> 2. - —` <br /> Date Time Item Location 1D# Unit Required Remarks <br /> —Gv far,VOA.50mlarl L Analysis Condition/Temperature <br /> _ brass Iubr.at.l <br /> 4 TTLC C3 TCLP <br /> O�STLC,if necessary May s ' C- 7 pari <br /> y '� <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> F <br /> m i7 ity, s❑pH <br /> / ltabilityactivi <br /> LC TCLP <br /> ❑STf.C,if necessary <br /> 096Hr"Is Bioassay <br /> ❑Cam 17 Metals❑pH <br /> ❑lgnitebility 0 <br /> Reactivity <br /> TTLC 0 TCLP <br /> ❑STLC,if necessary <br /> ❑W6 Hr Fish Btoassay <br /> ❑Cam 17 Metais❑pH <br /> (]I gnitability <br /> RexRvs <br /> TTLC TCLP <br /> ❑STLC,if necessary <br /> ❑WHr Fish Bioassay <br /> ❑Cam 17 Metals op" <br /> ❑Ignitability <br /> Reutivi <br /> TTLC TCLP <br /> []STLC,if necessary <br /> [196-Hr Fish Bioassay <br /> (3C am 17 Metals❑PH <br /> ❑igsitability <br /> Rfaetivity <br /> 3. X Evidence tape 4. Q Sample transported in iced cooler <br /> 5. Relinquished by 5 Coo✓d <br /> NA me Tit a Date Time <br /> Received by T �l , {_� .1,tC,. , Li�� I/,, , j ",•�+ <br /> Name Title Date Time <br /> Remarks (condition/temperature) <br /> •nom C_ � <br /> 6. Relinquished by �[.Lr� �A— s s'�..-,dr rr , .�1 ,�c�.y, .��•� <br /> Name Title Date Time <br /> f � <br /> Received by�i ce; r 1.. r * _, I -�� <br /> s <br /> Name Title I I Date Time <br /> Remarks (condition/temperature) <br /> 09-07-2007 <br />