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ENVIRON CHAIN -of -CUSTODY 02233 - <br />6001 Shellmound Street, Suite 700 <br />Emeryville, Wifornic 94608 <br />(510) 655-7400 PAGE —1— <br />(510) <br />(510) 655-9517 (fox) e's <br />PROJECT NAME / FACILITY ID: qA F-Aer"q I-ccA'w(qi%t5' I wc. T FIELD PERSON: Ut 'ASiVA SMI <br />PROJECT NUMBER: DATE: 16 Z? PROJECT MANAGER: 94AIJL VO -A <br />PROJECT LOCATION: 1401 41",- -IALIk- 2,00, Lalga— CA LABORATORY: AGCY 1`44(aell Anaki;—c4l Inc. <br />IS THIS A UST PROJECT OR IS EDF REQUIRED? Y (SO IF YES, GLOBAL ID #: - WO#: <br />SAMPLER, <br />YEAR <br />Uj <br />a_ <br />2 V) <br />CL <br />U'j <br />Lj <br />a- <br />< <br />1 (n <br />ix <br />— <br />X <br />4 <br />V) <br />Ix <br />z <br />p <br />z <br />0 <br />w <br />2 M <br />Z I- <br />— <br />w <br />w <br />-1-j <br />2 <br />> <br />wt <br />COMMENTS <br />SIGNATURE: <br />Uj <br />a. <br />< V) 1 <br />SAMPLE I.D. NUMBER <br />5&�efc A <br />/0/1 <br />11"'014A <br />S <br />- <br />I <br />-U. <br />Lk <br />Wo <br />I. <br />c <br />z <br />0 <br />z <br />-Z <br />M <br />II <br />TOTAL <br />N <br />XX <br />X,qX <br />I <br />I <br />RELINQUIS TIME DATE: <br />n113 <br />TIME DATE; <br />(CO. Z;4 1 V -6z <br />TURNAROUND TIME SAMEDAY 72 HOURS <br />(CIRCLE ONE) 24 HOURS 5E0>II <br />48 HOURS NORMAL z <br />S y'V --7 TIME/DATE: <br />FNQUAtSHE <br />1IRMENP'BY; TIME/DATE- <br />(COMPANY )0)15114 <br />------ --1 <br />SAMPLE INTEGRITY <br />-Z <br />INTACT; Y N Temp <br />11 SEALED, SEAL INTEGRITY <br />INTACT: Y N <br />RECEIVED BY: 41 -TIM DAE: <br />(COMPANY): <br />Page 24 of <br />