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4NAIN OF CUSTODY RECORD 1tT0 <br /> N La <br /> Sherwood P01Box 937 er AvenueL21�1 , A f7-z�,2910 <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention Pho / <br /> CR P O R A T 1 0 FAX (209) 667-2581 Page of <br /> vr"7 L O7 Z?&,4-7 C) 74 <br /> Job Number 11130# Project Name �1 <br /> Sam ignatu ) <br /> Site Address vGj ry01 O� m <br /> 1 ._� �� OOH �¢,`' �} Cz T-> —r6�, <br /> NUMBER TYPE ` �� �Uf ►7:L < <br /> SAMPLE LOCA ION DAT TIME SAMPLE Al �i .Z I► <br /> (IDENTIFICATION) (MTHIDAYIYR) (HOUR/MIN) OF (GRAB IT MATRIX '�� Q� til �'" J`r� <br /> CONTAINERS COMPOSITE} � tl` � � REMARKS t' 1 <br /> n <br /> 1117101 <br /> r f <br /> x 7)f 1 �T <br /> x ) <br /> 74 , <br /> zf <br /> ly Wig 6D A 9- <br /> IvK <br /> �J <br /> r� �f 0 y` <br /> S75- <br /> R ur8tiyI By/ptr1mvj j Date/Time Received By (Signature) DatelTme <br /> TURNAROUND TIME <br /> � t it <br /> NO <br /> r� <br /> Relinquished By (Signr <br /> Date ime Received By (signature} Datefrime 24 HOUR L148 HOUR ❑ <br /> Relinquished By (Signature) Datellime Received By (Signature) DatelTime 5 DAY ❑ <br /> DISTRIBUTION Ongmal-Accompanies Shipment Canary Copy Sherwood Pink Copy Sampler NOTE Samples are discarded 30 days after results are reported unless other arrangements are made <br />