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s <br /> )IVERSIFIED ANALYTICAL SERVICES CHAIN OF CUSTODY RECORD' <br /> N VIR O N NI E NT A L LABORATORY 3732 W. Century Stvd. <br /> Phone: (310) 671.5346 Btdg. 1 Unit 3 <br /> FAX: (310) 671-7216 Inglewood, CA 90303 Date: � `1'�" Page Z <br /> Project Name c-�XOP-&O ��� 04-lz �GA.eq <br /> Client: � `cam �� � D ^' [, <br /> Project Manager �crSS � Phone&;P,)y� Z. <br /> Address: o <br /> Sampler Sig ur <br /> Sample Location S pie Type _ No. of Tests <br /> Uumber Description Date Time Liquid Air Solid Cntnrs Required <br /> Comp Grab <br /> f3G -15- <br /> X <br /> 11"Zi <br /> X36--so i�;�a <br /> Relinquished by: c �r d Recd by: Date lime <br /> Relinquished Recd by: <br /> Relinquished bye Reed bye <br /> Relinquished by: Recd for Lob by: 3� 1qJ- <br /> 0pKethod of Shipment: tj <br /> speclat Instuctions: <br />