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4946 Watt Avenue, #38 <br /> X C e 0M North Highlands, CA 95660 CHAIN-OF-CUSTODY RECORD AND ANALYSIS REQUEST <br /> Environmental Labs (916)334-8661 <br /> Pro;1,wMev Phone#: TAT <br /> ana7 �4em 07770Z�171 ANALYSIS REQUEST <br /> Com anyyAddress: FAX#: E.T.(e) <br /> 40111^1 al- .-P/?(f 3t <br /> Project Number: ROA Project Name: -1� <br /> LL: 0 <br /> 5T-octroC\J nl 0 V�r-Y&-7) 5 &0(57Y- 4)?S'F1J (c C- Ld -r- <br /> co <br /> 0 't <br /> m <br /> Project Location: Sampler ign ur w to (D <br /> w w <br /> Ots rw <br /> .2 <br /> z 0 .?: S co > > <br /> 0 a) flo = CV Ir Cc <br /> CL 0 0 — w w <br /> Method cli 0CO <br /> a_ t T 0, ;� Z Q Cf) (n <br /> Sampling Container Matrix 6 0 < o .5 , -'r <br /> C> 0 -FD "' 0 a). > <br /> Sample Preserved 0 -E2 cm ca -7 t ❑ ❑ <br /> co w .6 -J Lu CC <br /> w U) T !R2 T T 0 .2 <br /> DATE TIME Ui < Lu z <br /> W < LU w < < < < < < < < <br /> 0 M M EL < <br /> -J 0 0 a, a- o o (L CL (L a- M 1X M < CL w X I�- <br /> > U) -J -J m z fn iD 0) w I w Lu Lu Lu w 0 tr 0 ul -i Lu (n <br /> C'J 'a <br /> tn a- <br /> ID > UJ WO COD 'C"i " 2 <br /> < <br /> X <br /> z < <br /> 0 <br /> 6-7/ 10 5--Z <br /> (2 5' <br /> 59',3 <br /> Relinquished by: Date Time Received by: Remarks- <br /> A�y <br /> 17067 --- <br /> Relinquished by Dale Time Received by: <br /> Relinquished by VL h-Date Time Received by Laboratory: Bill To: <br />