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L L L [ I l <br /> 0409497 Page_I.of7th 1 <br /> lMa c%k:SCA Chain of Custody <br /> I49edcrrtn,f.a <br /> (209)5224119 Fax 5224227 <br /> E-mail! Analysis Requested LAboratory Name and Address' <br /> Project ff: ClionUProjeot Name: r- <br /> -�5b, D- Cts Q ,(� a . <br /> 971 le Addresa; <br /> CA cs Purchase Order# <br /> Remarks.: m <br /> "n,`�� �l EDF Report: O Yes <br /> Sump {print and sign nama) o 1 f Turnaround Time• = tandard <br /> c7 <br /> u- L. Pa-U o t E 1 day,2 day,5 day, <br /> Date Time sample I.D. z Remarks <br /> 9b-24&4 a , , <br /> Q <br /> ti <br /> Re' qui Y. rte:ur�e) Dale: Time: Re eived by:(signature) Date: Tlme: <br /> u I o f 5 . t111A'1' )w Li Le,.,E? <br /> Selinquishe :(%ikpature) Date: Time= Received by:(signature) v Da : Time: <br /> Fielinquishad by".(signature) Date: Timm RReivt!d by(st re) nate: Time- <br /> M u� YQ <br /> Please return coclerfice chest to Geological Technics Inc. P � , C)tiC*too -1C4€ Reuarzaom <br />