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CHAIN OF CUSTODY RECORD <br /> Ship To Page of / Analysis <br /> Atm Project Name_ -Q-J 0'-A' y <br /> la reA v C Luvsr G+Rcla Project No C"'G' 9 Z Z <br /> _ Su 11 R. A Site Location S a c t'rr,v �f <br /> Syor leto S"20 Date <br /> oq - l3yo ' <br /> Sample Type $ Sample Containers <br /> Sample ID Depth Date Tune Waterl Soua I oto v 0" vo1 No Tri I PM REMARKS <br /> H z S X IAC S S Tu 1!? <br /> yL .30ii Zr X ✓ s <br /> i <br /> i Total Number of Samples Shipped Sampl 's Signature <br /> Signature Company Date Time <br /> Relinquished by n, [.J <br /> Received by U <br /> t <br /> Relinquished b <br /> Received by - <br /> Rellnqulshed by <br /> Received by Y�y Cr?Li AL <br /> Special Instructions 1 Shipment/Ha4ding 1 Storag equireme - ENVIRONMENTAL SOLUTIONS,INC. <br /> h sA yO -2-.417P T d C 2815 Mitchell Drive,Suite 103 <br /> Walnut Creek,CA 94598 <br /> (415)935-3294 <br /> ❑ ENVIRONMENTAL SOLUTIONS,INC. <br /> ��F� I /P$S 727 73x0 <br /> 21 Technology Drive <br /> Please send signed copy with results to the ATTENTION OF t 7 Irvine, 92718 11 <br /> at the address to the right indicated by an® (714} ]2 <br />