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LAB --�'' �` - EQUIVA Services LLC Chain Of Custody Record L�3LKd <br /> Lab ld°ft14e°°°(W"°°°"°") Equiva Project Manager to be invoiced ?"` <br /> Address <br /> �vm ai Karen Petryna 9 3 9 9 61 11 8 1 3 DATE /�- 'CY <br /> City Stats Zip <br /> �i�TEf}ENFCIL 52RVfe_SE_$' I I{I ��v c� g, tr �; <br /> PAGE z a <br /> , I <br /> a+Hruuo COMPANY LOO CODE. I sT1i E ADl1REJ18 ESATed area Clyl' OLOEAL ID NO_ <br /> Blaine tech Services sTSR 4315 Waterloo Road, Stockton T0607700400 <br /> ADDRESS EOF DELNEIMLE TO M*WwnW PWr a D61*0e16 PHONE NO Fl—c"I <br /> L CONSULTANT PROJECT NO- <br /> 1680 Rogers Avenue,San Jose,CA 85112 it 11 <br /> PROJECT CONTACT pr�ePyl v MW Repel loK it Aubrey Cool 1707-M-2368 mbrta-env com BTS •Nick Sudano ER ts]NgcvH ,r= <br /> TELEPHONE i C 'I '� ` tick✓ ,f�^ '' <br /> FAX <br /> 408-673.0666 i' iv"Ir . r ,I <br /> 408-673771 nsudano@blalnetech cm3 � s <br /> # , 9 <br /> , <br /> ', rr <br /> TURNAROUND TIME(BUSINESS DAYS) <br /> l9QAY5 ❑ 5 0AT5❑ n HOURS❑ 48 HOURS ❑ 24 HOURS❑ LESS THAN 24 HOURS REQUESTED ANALYSIS__ <br /> ❑ LA RwQm REPORT FmRHAT © UST AGm4cy. iI <br /> GCIMSMTBMA <br /> ECONFIRTION KGHESr HIGHESTpwBORM LL..-A �I o FIELD NOTES- <br /> SPECIAL INSTRUCTIONS OR NOTES' TEMPERATURE ON RECEIPT CIL <br /> �� � m ; `� ContatnuJPrasarvatlw <br /> q or PID Readings <br /> s� L or Laboratory Notes <br /> I b o <br /> i Field Sample Identification s PLtNa MATMQ cc TP w w e p = m <br /> DATE TIME r I` � � � 0 � � � w <br /> A x K <br /> do <br /> I <br /> I I <br /> I, <br /> e <br /> RetWAstWtyf(SWAIIre) RecdwdSyrLa—WAfue) u i <br /> t <br /> RdrglltMd trr(OF-IN) Reedued br{s�prd.rq , <br /> tl . 1 <br /> Reln0*adbf(31Oahre) dvedtry(Sosahre) i ode Tk*Z7 Ar <br /> T <br /> C <br /> D15TRi9v NhllWrel+aq GrwtoF%YeSowwWPkkfoCbnL li �� lamaqw <br />