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i <br /> Trw"Emio CHAIN OF CUSTODY RECORD Page Lof� <br /> EnvuOnmenlal and Geotechnical Consultant 555 Montgomery Street,Suite 1300,San Francisco,CA 94141 Ph 415.955-90401 Fax 415-955.9041 <br /> 2 Theatre Square,Suite 216,Orinds CA 94563 Ph 925.25349801 Fax 925.253.4965 <br /> Site Name 501 14th Stret•,3rd Floor,Oakland,CA 54612 Ph 510.87445001 Fax 510-9744507 <br /> Job Number An sls Requestedi <br /> Project Manager%Contact G rl <br /> Samplers <br /> V <br /> Recorder(Signature Requ red) No ContainersCL �24 1136 <br /> Matrix &Preservative 1 I <br /> I <br /> FieldSample 0Y " „ m ice ' <br /> ..ter . �.,.. <br /> Identification No Date Time Lab Sample No m O 3 M a o CA _ � !� Y r � V <br /> e .J1J r x Remarks < <br /> 6 <br /> XIt Pmt CZ-T-y <br /> Ain I` <br /> 1' 8 Rs <br /> r PRtee�T4' t <br /> �e�ar�tT� 1 <br /> ecenred On Ice <br /> le ntact <br /> 414 <br /> Relinquished b ignature Date Time Recei ed by (Si tute) Dale Tk* <br /> G Z� b t2.4C <br /> RelmgwshPd ignature) Date Time R ived by (Sig ure) Dat Time <br /> i <br /> Relinquished by (Signature) <br /> Date <br /> Time Received by Lab (Signature) Date 'Tune <br /> Sent to Laboratory(Name) Method of ShipmentLab torr,i r OFedEx ElAirbome DUPS <br /> Laboratory Comments/Notes Hand CarnodElPrivate Couner((.o Name) <br /> White Copy-Original Yellow Copy-Laboratory Pink Copy-Field COC Number <br /> 003319 <br />