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• SEP 19 RECD <br /> AIR SAMPLE CHAIN OF CUSTODY RECORD <br /> LAWRENCE AND ASSOCIATES <br /> 1730 South Street <br /> Redding, CA 96001 <br /> < (991 6 ) 244-9703 �y <br /> Client:_ )/i mJ2SC11 tj 1< Pott Date: -Zq -czd <br /> Project: �etlov0.� tt Job #: C,��,��.� ( <br /> Laboratory: L� r-E,�S C,NA 1 eNokin�5 JOS <br /> Address: <br /> City: �ec��l2V State: Com . Zip 947/6 <br /> SAMPLE INFORMATION <br /> Date C) Ti-m7e Location Analyses Requested <br /> 1:4-1 l ufD 5T- Z <br /> kA G S—i <br /> n <br /> Sampled By: ^�Nr4' Date: �3 3�4 - f3R <br /> Shipped By: P_�Sc.✓ Date: -3O- Time: <br /> Shipped Via: PS I kFroa: 4. <br /> Received at Laboratory by: 41.41 <br /> Title of Recipient: <'�'Q , Date: 3\ Time: <br /> PLEASE RETURN A COPY OF THIS FORM WITH THE ANALYSES <br />