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-F.r <br /> "DELTA Sample ldentification/MeW 'bain of Custody'Record <br /> ENVIRONMENTAL CONSULTANTS,INC. <br /> Projea: C-L �&A-.{ _ d <br /> Shipped by; L�'Iiv (! 3'r ���'rs v �- ,• , W.d. # 0' <br /> Shipped to: a Cc " <br /> Comments: Attention of. 4s <br /> I—( Hazardous matoriais suspected?(yesino) <br /> Sarripting <br /> Print Sane <br /> Location Field ID N gala Type Contarnara Anatyeie k <br /> _ T Requ"d <br /> 0 Olt. <br /> j 4i <br /> r t� <br /> 't 5c3 Dr9 <br /> g to <br /> C J e3 <br /> r <br /> Sampler(s)(signature) ^�e Vin.- ��� �p�v� �� 11A # <br /> Field ID Refinquishtd by:(signature} Received by:(at nature i Y' <br /> Y } DateJTime Comments - a <br /> I` A <br /> �. <br /> ,d for shipment by:(signature) r•f <br /> —�,•--��_ Date/Time Shipment method: �m�� u <br /> �' <br /> for Lab by:(signature) Date[Tin'.e Comments <br /> Asr <br /> ^ ^`"'�^r-'�rrnt�r�•piens relum nrininat form otter signing for receipt of samplas. <br /> Se- k <br /> �� tl <br />