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.1 <br /> Cisglobal Environmental Geochemistry Chain of C ;+dy Record PO M SSS_ �!r -JN -, <br />` Client: Date:_ Page 1 Of M' <br />! Address: L6! - C L-!�S 'r C TEG Project#: 9 0 10 8 G Outside Lab#: ,r <br /> Phone:C� � '��'FC-3'7')�FAX: tZ� {6) j -g�`cC3 Location: c C-A- <br /> Client Project#: SSSS-`f I I- I �� Project Manager: r i Collector:_.Ler Date of Collection: zzzf4a <br /> o <br /> N <br /> O m.- O V <br /> n °0 _� 1e7 119 1n a e <br /> Sample Container o x x x ai W <br /> Sample# Depth Time Type Type W CL I Field Notes o <br /> z_ -y y:I I <br /> -!Q tt-q.S' IS:I0 X X I <br /> ' s-rf X X r <br /> Relinquished by: (signature) Date I Time Received by: (signature) Date I Time Total#of containers: Notes: <br /> Chain of Custody seals YININA JC/ <br /> T, 2 y 9 �7, r z/�I9? r 7:/� Seals intact? YIN/NA �✓rt- �� <br /> Relinquished by: (signature) Date I Time Received b /(signature) Date 1 Time Received good condition/cold le. La-_[ <br /> Turn around time: <br /> Sample disposal Instructions: TELA Disposal @$Zoo each __Retum to client Pickup <br />