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Ix ALPHA SCIENTIFIC CORPORATION <br />CHAIN OF CUSTODY RECORD <br />Page R of —' <br />Lab Job Number .7 I �" 1 t <br />Client- F.NVIft ArpP L-1fhTt041J <br />yRequestedT.A.T. <br />Analyses <br />R nested <br />,FNT f, -t- <br />tish 8 12 24 firs <br />2-3 daysallom�al <br />Address <br />2120 NvrJ7l1�crdJ Q2ivF� SU1Tf 3t)t) S PASk�F/✓A (A cltciD <br />m <br />Report Attention <br />Phone <br />Fax <br />Sam I d,by <br />Sample Condition <br />E0 �lz��.� <br />��)�-4Y'�r, <br />(.rz,� f� ��,,— <br />r� VJ/�J< <br />o <br />v <br />y <br />X <br />^ <br />U <br />a I <br />Iled la�wtact <br />Project NamelNo. <br />Project Site <br />(,a,oA) l:�i'=rr��iiftlll <br />v <br />0 <br />� <br />�� <br />O <br />Sample seals <br />Sample Collect <br />Na.,type* <br />Remark <br />Client <br />Lab <br />Matrix <br />Sample <br />& size of <br />o <br />o <br />N <br />N <br />N <br />Q <br />_ <br />Date <br />Time <br />Sample ID <br />Sample ID <br />Type <br />Presery <br />container <br />°O <br />00% <br />07 <br />- <br />- <br />D' <br />r <br />�. <br />�' <br />41_,1ro F� <br />X, <br />T <br />Relinpuish py Company <br />�( <br />Date <br />f• -"G t- <br />Time <br />; tl L <br />Received by Xpany <br />�/ gL. <br />Date , Time <br />d LIJ.CC d� ZA,y <br />Container types: M=Metal Tube <br />P --Plastic bottle <br />A=Air Bag <br />Relinquished by Company <br />Date <br />Time <br />Received by Company <br />Date Time <br />G --Glass bottle V=VOA vial <br />Alpha Scientific Corporation Note: Samples are discarded 30 days after results are reported unless other arrangements are <br />16760 Gridley Road Tel: (562) 809-8880 made. Hazardous samples will be returned to client or disposed of at client's expense. <br />Cerritos. CA 90703 Fax: (562) 809-8801 Distribution: WHITE with report, PINK to courier. <br />