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BC LOG NO. <br /> CHAIN OF CUSTODY RECORD Analysts required <br /> Job number <br /> Kant name / I 2/1 <br /> ^ P <br /> e Trofte 5 ��1Y1 <br /> SemDierlsl `D <br /> rolect manager <br /> Number /t{',{j` �� ` ,q ���b�,� Remarks <br /> Ly P-4 <br /> Time composite Sample description of <br /> Sample Dau 0 containers <br /> lumber sampled sampled or / b <br /> Grab <br /> V�ef�ttak�l W•,�c,°tR <br /> t,TIA 5 '481 If : 3S G it Z <br />,C', -lr3 5-14-49 11 : 50 <br /> 8 ruw K <br /> 0' r7 ;z,- rr S 5 trtia <br /> �acrccm.e✓r-f-D '75g18 <br /> r�{Jei9�brl <br /> r\J>/fahna A??!hle <br /> 4y ,4 - of 3 <br /> Date Time <br /> Company <br /> Signature 5-14- SI <br /> 3 • P <br /> Relinquished y /y_ <br /> Raulved by <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by <br /> BROWN AND CALDWELL Analytical Laboratories Note: Samples are discards"ingred nt days after results era reported <br /> �-7 unlcu other amngemenU are made, <br /> 1255 II Str eryvllle, C 608 141 428-2300 Hazardous samples will be returned to client or dlsposed <br /> C 71 31 681-4655 of at client expense. <br /> '�3�y <br /> sou"air Oaks Aven �esaden , <br />