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Mont <br /> H Y D RBatch No <br /> EN V IR � MENTAL Chain ®� CustodyCA PO-2089 <br /> TECH N �. OGIES, INC <br /> 2394 Mariner Square Drive, Suite 2, Alameda, CA 94501 Page r of )- <br /> 510-521-2684 (voice) 510-521-5078 (fax) Date 7/ 13 12000 <br /> Lab Name TEG Analysis Request <br /> Address 11350 Monier Park Place <br /> h <br /> u <br /> Rancho Cordova, CA 95742o <br /> CD o �, o a S <br /> u w oa F w rvo ry r O K arvo C <br /> Telephone 916-853-8010 z wo y ry o N 3 0 7 <br /> E y li o <br /> Samplers(Signatures) d Q F K o n o ¢ U <br /> n a r y U OU o0 00o V oc a° W p ri d `o <br /> L] ts1 ¢] <br /> m m rr, X o a o = = UU > U o m 6 w vs <br /> a s �F a a a a o o O E S °[ m ° n <br /> Sample Number Matrix Location I 1, p Cc p E, r- E, > > > n a a k C4 a` 1-= z a t- a a z <br /> 1 0007 <br /> z 0007 [ 3 [ to u t rz.moi u Q— 3 <br /> 60)7 <br /> 4 0007 <br /> 5 0007 <br /> b 0007 <br /> 8 <br /> 71 <br /> 9 <br /> ID <br /> Protect Information Sample Receipt Relmquished By I Relinquished By 2 Relinquished By 3 <br /> Project Name Total No of Contamer5 <br /> Central CA Traction CoL— CO <br /> Project Manager Chain of Custody Seals (Signature) (Time)( i n re (Time)(Signature) (Time) <br /> Avakian -S—o f r?N'x4(� 41,,4 <br /> br) <br /> Job No ^ 'y <br /> Rce d Good Condition/Cold (Printed Name) (Date)(Printed Name) (Date)(Printed Name) (Date) <br /> 007-3 <br /> Shipping ID No `t Conforms to Record (Cot-mlpanny) (COMWY) �` r 01] (Company) <br /> 94 A1 le, Ivy <br /> Lab No Received By I Received B r 2 Received By (Laboratory) 3 <br /> I Lind 20 <br /> 5l)l,U 111111i rill ilURS�L.UII[till rliS (S ign nurc) (IIm2)(Sibnamrc) (Time)(Signarorr) (Time) <br /> 'VA�� 7-13 2V E FWA rY <br /> ;landard Iit[[iArOUnd I 111111 (1'nnw(�-d�Nnml (1)Ile)(1'nntcdNsn,r) (1)nr)(PrinmdNdme) (Date <br /> '1 <br /> \ E V - 0, L [ av <br /> 0onw-y) ((onq,u,y) (L,aboratory) <br />