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Trace Analysis Laboratory, Inc. Telephone (510) 783-6960 <br />' 3423 Investment Boulevard, #8 • Hayward, Califomia 94545 Facsimile (510) 783-1512 <br /> CHAIN OF CUSTODY RECORD <br /> Proj.No. Project Name <br /> I)-)D5' 0 ji VGGZ.rNa. Qr <br />' Analyses:/ <br /> Company Dame andAddress: <br /> !(Z5 �4f'laKff c- �� of <br /> a *2.c w ? gal <br /> Project Manager: <br />' Sample Date Time Site Location Con- <br /> ID <br /> tamers REMARKS REMARKS <br /> MW-� ' / ' 1' <br /> O <br /> t <br />' kW-3 1-41 ' <br /> w-3 <br /> pled by: (signature) Date/Time Relinquished y.�ss lg�nature) Date/Tim <br /> 1�T �, <br />' R calved by: signature) - t � Relinquished by: (signature) D to/Time <br /> ` 4 Z/- <br /> Received <br /> Received for aboratory r (signs ure11 <br /> te,/Time TURNAROUND TIME <br /> REMARKS Sampli recei t mul be d in by lab <br />' Ambient - - - - - - - <br /> Preservative:- ' <br /> rvative:_- � <br /> Heads ace: <br /> Container Type: 9,-ass Y - <br /> Total Number of Co ta ' e <br /> Other: <br />' PIU r S.-' J- - 13-r e4w� a n ,ti , <br />' Founding Member of the Associetlon of California Testing Laboratories <br />