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CHAIN OF CUSTODY RECORD <br /> -Ch Log Number <br />! t► .Cli nl naihe':; Pro1ecl or PON Analyses required <br /> !L� <br /> j AVOdress <br /> Phone N N <br /> Cil ate,Zip Reporr attention <br /> Lab Tempe Sampled y Jy Hca <br /> LU Number ao�t <br /> Sample Date Time See key of a ya�0a <br /> number sampled Sampled below containers V yQ <br />! Sample description Remarks <br /> �Il ;5 DT ✓' <br /> E-1c <br /> I <br /> r <br /> Signature Print Name Company Date Tums <br /> Relinquished byKo _A0A1 Z—��J�rkre/o L—U4 <br /> Wn <br /> 7 <br /> �d✓' <br /> Received byV61j'eh <br /> Relinquished byAl <br /> Received by <br /> Relinquished <br /> i <br /> Received by Laboralory <br /> ANALYTICAL NoW Samples are discarded 30 days alter results are reported unless other arrangements are made. 'KEY: AQ—Aqueous NA—Nonaqueous SL—Sludge <br /> ❑ 5255 free ryvrrr� die,CA 94608 (415J 428 230U Hazardous samples will be returned to client or disposed of at client's expense. GW—Groundwater SO—Soil OT—Other PE—Petreieuns <br /> ❑ n Avenue. 91201 �B18)247-5737 Disposal arrangements: <br /> 1200 Pacifico AvEnaheim,CA 92805 78.0113 t �� <br />