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A� <br /> CENTRUM ANALYTICAL LABORATORIES,INC. (J� <br /> 290 TENNESSEE STREET REDLANDS, CA 92373 • (909)798-9336 <br /> CHAIN OF CUSTODY RECORD PAGE Z OF <br /> Job No.: Project Name: \ Analyses required <br /> Sampler: _S Phone: <br /> Client Name: Address: ( /r Vi"t 112— C� 0 <br /> Q y�ca 0y <br /> V19 <br /> Sample Type # and ,(�� d.. z� cR <br /> Sample Date/Tiof <br /> me Site Location GGC1 <br /> b� <br /> Remarks <br /> Number Sampled 0 O N containers V� �Q� �� and observations <br /> G c 5� t5 �D <br /> �1 a-- <br /> S L17 <br /> � — s- <br /> �q HDL <br /> IV <br /> I — <br /> �d S <br /> lY _ ; <br /> Rel ui by: nature) Dat (rime Received by: (Signature) Relinquished by: Signatur ) Datelfime Received by: (Signature) <br /> linqui hed by: (Signature) D teffi a Recna a <br /> eiv f r L rat ry by: 5mySamples chilled Yes(Sigy J v Samples sealed C7 Yes No <br /> Method of Shipment <br /> The delivery of samples and the signature on this chain of custody form I ; Courier - PS ed-x 1, Mail I I Hand Carried <br /> constitutes authorization to perform the analyses specified above under <br /> the Terms and Conditions set forth on the back hereof. <br />