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IF If <br /> INTERNATIONAL R/A Control No. <br /> TECHNOLOGY1B CORPORATION CHAIN-OF-CUSTODY RECORD <br /> C/C Control No. 001632 <br /> 1 �ZJ Z <br /> ., <br /> PROJECT NAME/NUMBER C-r ..+t,.. « v +� .rr. nnco LAB DESTINATION �� 6erritea U <br /> SAMPLE TEAM MEMBERS Peggy Llewellyn CARRIER/WAYBILL NO. <br /> Sample Sample Date and Time Sample Container Condition on Receipt Disposal <br /> Number Location and Description Collected Type Type (Name and Date) Record No. <br /> CIAT", 1 0 0 <br /> Lab # 34487 (stoner) 11:00 am <br /> CART - 019 Borehole P-7 15-16.5 fe t 11/26/85 soil " ass <br /> Lab # 34483 ( stoner ) @ 11000 <br /> r <br /> Special Instructions: GIZ/NassspeeAr ewtFaerp4leer-,�3s__g <br /> Possible Sample Hazards: _no r1gai4if1rant. �� �-as <br /> SIGNATURES: (Name, Company, Date and Time) <br /> 1. Relinquished,b%A. S o IT C orp to Fed Express 3. Relinquished By: <br /> /O: ZO <br /> Received By: V Received by: <br /> 2. Relinquished By: 4. Relinquished By: <br /> Received By: Received By: <br /> WHITE-To accompany samples <br /> YELLOW-Field copy ` <br />