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ENVIROMETRIX CORPORATION CHAIN OF CUSTODY RECORD <br /> 3950 Industrial Blvd <br /> y Suite 200C Sample Collector <br /> 180"n;4 Co (J;'(1, Date/Time 5 f fY f yG <br /> West Sacramento CA 95691 <br /> Phone: (916) 375-1000 Signature of Collector <br /> FAX: (916) 375-1024 LABORATORY: <br /> ENVIROMETRIX <br /> REMARKS: <br /> Project Name: In f_ B�ae�l��e N.� Job A: /963y1AJ--/y QA f 4 L - as j +�venarb�� <br /> Project Location: f 7tec4/e. Project Manager: o.,h 4n21 <br /> Turn <br /> Around <br /> Sampling Q ix g Time <br /> 0 <br /> JUN 2 5 1996 0 <br /> LQto <br /> N <br /> ENVIRONMENTAL HEALTH _ I <br /> - <br /> PERMIT/SERVICES — M co <br /> m O N v V <br /> 7 c v1 O EL <br /> = m <br /> Z C m O i¢ N <br /> x x _U a Q 'n <br /> Q w w 2 Q C c t <br /> SAMPLE ID Date Time DESCRIPTION ° LU 3 F <br /> Ui <br /> Relinquishe y I Rec d b�,y Re1in uishe by: e-+5-# Received by: <br /> Date: s fS Time: /G Date: � Date: Time: Date: <br /> C AINCf)_rkcnnnl �nimF <br />