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Calscience Envirlental Laboratories, Inc. • CHAIN OF CUSTODY RECORD <br /> � Spee(LiE)eermary Narem$erwenle <br /> eCe , �n �0`i —O7 <br /> Gt <br /> 7440 UnPaln We, 5063 Cpmmere al Garcia,Suite H Data <br /> ` GdrdeOGrgie.LA92041-142] Content,CA N52D 05]] <br /> (714)8955494 (925)689&90?2 Pepe <br /> ' UBOMIORY CLIFNi: n CLIENT PrRROJECT N,.yath)e I NUMBER: P.O.NO.: <br /> T4!Yy 4<lRG Z' /{ADT- <br /> ADDRESS: ,a / /'/ <br /> /39aD ?� µE, DYf /zz PROJECT CONTACT //'' /I IAB USE ONLY <br /> CITY -/' STATE p SIP SldMW 6'.PLL q � ® 0�1 <br /> Y/YVLL /Z Jp' SMIPLE (P/UNG COELT LOG CODE COOLERRECEIPT <br /> iL: -29 y E4MIL' C a xeWlrPy LJ s-y� ❑❑❑❑ TEMP= 'C <br /> M aaouxD Tn4e REQUESTED ANALYSES <br /> ❑SAMEMY ❑24HR ❑0 HIRCOTS ❑RHP SMYS F1 DAYS <br /> [I RWSPECIAREQUIREMENTSµDD1TI0NAL COSTS r ELTAPPLY) yy <br /> ❑RWOCB REPORTING FORMS ❑COELT EDF ❑ <br /> ' SPECIAL HISTRUCTIONS. N h b <br /> 'FOSE <br /> ce^j, Fe $ a oro <br /> Uo C3 6 a + <br /> ' o <br /> ISO 0 0 �. n m u m m /rpp <br /> Zi s q _ a- <br /> Ip'd FIELD POINT NAME SAMPLING M0. Z W <br /> USE SAMPLE ID wBAls pr x i f 0 $ 8 m " S LS 2 <br /> FOR COELT EOFl ppiE Ty,IE r p, D' <br /> F- f 0 > > N LL 1 O. C V <br /> xLrsl - = I°C /0-9-0 7:5`0 11 <br /> ' 2- s'rK -S.v 1 Z:DD <br /> ST K-1-9°S $:IS <br /> STK-2-ors <br /> STKz -3.a '.30 <br /> sr a s.o ;oS <br /> � s1K-i � .s •.00 <br /> SSK- 3 <br /> 10 S -3 53 <br /> Rerngwsnea by:(Sigmaturel <br /> "A711a 5'naturelARliatlonl Data Tine R <br /> �a+ lYza <br /> ' Relinavisned ey'.($ignalu 1 Re d y:l5gnalurmA151iallon) Oale: ime: N <br /> RelinquisM1etl ey'.I6ignalure) Re -eE By:IBgnRurelAllillalion) Dale �/ Time: re <br /> /�]— Q D O <br /> DUGA BUGON:Abbe Mm MalttgR Glean and YNbw IOCIPUIL BSgIIUl ReY4bn <br /> Pleese nde IAaI pees 1 and 9 d S olour T/Cs aR prMIM an Vre meM title UIIM green arm Yetlow-,ieueapa 1"MYy <br /> Calscience Environmental Laboratories, Inc. CHAIN OF CUSTODY RECORD <br /> ' A � S4LalLine-in <br /> ney Naremserc el ms' Data 10-o9-O-7 <br /> ]410mn Way 5063 CommCircle,Suite <br /> = GardennGiGrove,CA 92811-112] Cement,G91520-05TT / <br /> p14)0955191 (925)609-9022 Pagepl <br /> poREss (D <br /> UBOMiOflY CLIENT, CLIENT PROJECT NAME(NUMBER: PO.NO: <br /> 1 v cr FI-E /03S <br /> -. <br /> 13500 PaT4„J $k 122 PROJECT CONTACT <br /> scoxIT'AcI�r �euse ONLY <br /> CITY STATE 0 <br /> :160 n <br /> O <br /> JTPyIOL G"l CI z ' <br /> LOG CODE .COOLER PEC1111 <br /> iEL E.NAR. LT ❑❑110 <br /> -N a� .CL'ti- ry TEMP= °C <br /> TURK EDA nME. d' REQUESTED ANALYSES <br /> ' ❑snMEDAY 24 HR ❑46TS ❑RnR E.v GAYS 010 Mrs — — <br /> SPECNL REQUIREMENTS ENiS(ROOITIONPI COSTS(MLT EOF) <br /> ❑RWOLB REPORTING FORMS ❑COELT EDF ❑ v <br /> SPELUL IxsTO <br /> TRULTIOHS: h <br /> t v m <br /> U v <br /> N o o � � d <br /> E m o n = g m To c Q 2 J <br /> W <br /> FIELD Powr NAME sNA9UAG ° x W pV o 5 V V y <br /> vtia SAMPLE Ip (EOR COEtT EDF)) PATE TIME nre card d F F o TO ei� U j 4 [ <br /> II STK`S-Or lD Ofi /lJ:UOJ/ I' <br /> 13 s-p-, '> - .o oils <br /> Ix <br /> y slit-S _ .5 yo:% <br /> o sM <br /> t�- 57 -4 -Ad / :/u <br /> Iq STK-y- o /s <br /> o <br /> Relinquished Gy:(Sipnatme) Receiv (s- alUrelAl50albn7 Dale' Time: m <br /> i0 i o i ZO <br /> Heantueredey;Signature) ReRiv y:($gnalUreJAffin. m) Dale: Tme: U <br /> 10/11'q me O e' <br /> RelinaubMdEy:(Signature) I Revived by.(SgnalurelAMNalon) / pale: Tme: re <br /> O <br /> O <br /> DISTRIBUTION:MR.will,fNm report Green and VERB.W CWM. 05101107 ReVNkn <br /> Please note tial pa0es 1 and 2 at 2 olwr TICS Be Prin40 on the reverse sMe of Ne preen and!YNMwwpks re[peclivety. <br />