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q <br /> CHAIN OF CUSTODY RECOlID <br /> Send Lab, Results To• (add below <br /> b <br /> res <br /> adds <br /> LSCC; ,. <br /> Ctienl name L$CE Project No. Anrage b <br /> K'Nc"2 i �c=�/t) S jq4 —I <br /> Project name <br /> Preieel manager Sampler g <br /> /vSc; ScNA D .r � , P.y LJ(c �5 i ti �.0 � a� <br /> TY <br /> Sample Time compWIS Date Number <br /> number "mpled 0 <br /> sampld e5+mpl+ dexriptiprti <br /> Grab (Location Details) of �:�' Remarks, <br /> cortlsin+rs <br /> I d' <br /> Matrix Z <br /> r -r Lu <br /> 1 1 <br /> D h S C,Cri B E W 2 X <br /> 2 12-0 i t t l SC"-la` P_NC.- e a o Z x <br /> 3 bC) 1r it KOSTCR Z X <br /> /o-T5 r r 1 I �l�to L_ NCS' <br /> S <br /> /its f <br /> *Sample Container Description <br /> t. Polyethylene. no preservative's 4. Polyethylene — sterile <br /> 2. Polyethylene, preacldified 8. 40 ml Glgss Vial, duplicate <br /> 3.- -Glass, screw cap 9. <br /> nalUTf Can n k <br /> � y Date i!mE <br /> Fixlinquished by <br /> Sic 7-L -1_s� lzn�� <br /> Received by All <br /> Relinquished b <br /> Receive4 by <br /> Relinquished by <br /> Recfived 6y <br /> Luhdorit and Scalmanini, Consulting Engineers <br /> 600 First Street. Woodland, Ca, 05696 [` <br /> Contact Person:_ � Nl'.�.`_-_a('HAAr <br /> .. Phone: (916) 661--0109 <br />