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ecFingy Analytical Laboratorjir <br /> LL- surTE 108 <br /> � as <br /> AiNENrp, CA 95827 p, SAMPLE # <br /> CHAIN OF CUSTODY RECORD <br /> ^j N <br /> tont II o 1741 <br /> CLIENT NAME <br /> S�C, PROJECT ADDRESS / r <br /> Nunber Street City Zip <br /> SAMPLED BY uQ's`s rr���� ../��lf_ CONTAINERS III ED FROM <br /> Name(PRINT) Oraanizatien <br /> PRESERVATIVE USED /CIE— STORAGE TEMPERATURE [] Ambient 4- C -100 C Other <br /> s9 <br /> HAZARDOUS NON-HAZARDOUS SPECIAL HANDLING INSTRUCTIONS <br /> It I <br /> FIELD REMARKS �I <br /> II! <br /> COLLECTOR DATE COMP GRAB TYPE FIELD STATION LOCATION A OF ANALYSIS REMARKS <br /> 1� <br /> SAMPLE N0. IS*dl DATA (arid.depth.etc.) CONTAINERS I REQUIRED <br /> 7 <br /> Mz01 �!,` q--bI F_5rc µLp'�O 1 L r <br /> -17 I pt 7-0,9-53 <br /> }t sa►� I° <br /> t Lf <br /> y <br /> II <br /> 11 r <br /> 1p i <br /> l <br /> r I r��R�f /C Z-tc <br /> r <br /> eased by Organization _ ! at ime !eeived by r iiati aterTime <br /> J, <br /> 3 <br /> Released by Organization Datefrime ece'sve by 0 Iza ' n Date ime <br /> y <br /> Released by Organization -Daterrime Received by Organiiation Datelrime <br /> jk <br /> LABORATORY SECTION <br /> TEMPERATURE RECEIVED FEDX AIRBILL# H aND DELIVERED <br /> ,I <br /> ANALYSIS RECORD I <br /> ;t <br /> TYPE OF PERFORMED BY DATE OF RECORDED II COMMENTS <br /> ANALYSIS (Signed) ANALYSIS (Late Book No.) ¢ <br /> I I <br /> I; <br /> 'I <br /> White -..Original______�__ __ Yeil_ow= Laboratory-Supervisors Copy �I Pink - Originators Copy <br />