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! CHAIN-OF-CUSTODY RECORD AND ANALYSIS REQUEST <br /> i <br /> PROJ.NO. PROJECT NAME <br /> ANALYSIS TYPE REQ1dESTEp <br /> { SAMPLER [. Platllre) w W <br /> !.I IL <br /> L <br /> z ii <br /> I.D.NO. DATE TIME G STATION i LOCATION U 2117 <br /> U 1 . 9 REMARKS <br /> WsPrkop✓ ti-n! 133s 1,26 <br /> F <br /> ! W6601 <br /> I <br /> I <br /> F <br /> a <br /> I <br /> i <br /> I <br /> 3 <br /> I <br /> i <br /> 1 <br /> PLEASE RETURN ICE CHESTS <br /> AND OWE ICE TO WATERWORK <br /> LAB. or.iNa;lt <br /> N/_. ".1/ <br /> Relinquished by: Date Time Recelved by Relinquished by Date Time Received by <br /> Relinqu stied by: Date Time Received by Relinquished by: Date Time Received by: <br /> r <br /> r <br /> I <br /> s Relinquished by: Data Time Received by Laboratory Date Time REMARKS(Shipping Related): <br /> rf <br /> 1710 MAIN STREET • ESCALON,CA 95320 • (209)838-350740"- <br /> - - - - ---- - <br /> 1 - - <br />