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WA� TICAL <br /> EMISTS <br /> CHAIN OF CUSTODY <br /> DATE: rl vl 8� <br /> CLIENT: Cr1512 TZ INk C] <br /> ADDRESS: � a �� O � d �d�/ G� 152-13 <br /> PHONE NUMBER: �1 <br /> PROJECT NAME : 65 f S M?L <br /> PROJECT MANAGER: LLay\(,�c4 Cry <br /> SAMPLERS : �W y� Qf0 pL <br /> Sample Location Date Time Number of Tests Date <br /> Number Description, Sampled Sam led Containers Re wired Needed b <br /> 1 <br /> 1 T2yk Lz C 41t1 89 3 :a4O L t L <br /> pH <br /> 2 TZ. 4� t ws� z1�89 <br /> 3' <br /> 1 ' <br /> 3 n> Z q z 8ct 140eln1 nf,T-i f <br /> Relinquished By: / Received r Date Ta <br /> Relinquished By: Received By: Date T' <br /> Relinquished By: Received By: Date <br /> MAIN OFFICE- 653 CORPORATION STREET- P.O. BOX 272 BRANCH OFFICE- 2500 STAGECOACH ROAD <br /> k LABORATORY SANTA PAULA,CALIFORNIA 93060-@72 k LABORATORY STOOCfON,CALIFORNIA 95205 <br /> (6(5)5253621 -(6)5)659-0910 a09)912-0161 <br /> FAX (605)S25-1172 FAX a09)912-0123 <br />