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ENVIRONMENTAL Weekly CHAIN OF CUSTODY <br /> Laboratory Copy (1 of 3) <br /> Illi 111111111111 IIIW1111i 111! 30007:04/05/2004 TEST DESCRIPTION - See Reverse side for Container,Preservative and Sampling information <br /> Client: Clark Well Inc. <br /> Address: 2024 E. Charter Way O <br /> Stockton,CA 95205 E <br /> r <br /> O <br /> Phone: (209)462-7676 Fax: (209)462-5597 a <br /> Contact Person: Mike'VClark <br /> , U W ea <br /> Project Name: mrn <br /> y <br /> Purchase Order Number: <br /> h a� <br /> V tat] <br /> 7 <br /> pler(s) <br /> o w z v <br /> u s a <br /> 3 F 0 <br /> or O <br /> Compositor Setup Dale:_/_/ Time:_/_ = e a H <br /> y <br /> E <br /> 6 ZO C z <br /> N <br /> Lab Number: STK 3-2343 <br /> `o u <br /> Samp Date Time �5 v n a E <br /> Num Location Description Sampled <br /> / Sampled �E FT- o°, on <br /> 1 ' S 1.1� . L, l �z I,G 3 G S. I <br /> Remarks: Relinquished Date: Time: Relinquished Date: Time: Re[i uis ed Dat Time: <br /> Rom �I IV <br /> Received By: Date: Tinie: Received By: ate: Time: i By: Date ,Time: <br /> YkLoly <br /> Goruorale Offices&Lab,,,t," Office&Laboratory Field Office <br /> P.O.Box 272/853 Corporation Street 2500 Stagecoach Fond visalia,Calilomia <br /> Sanla Paula,CA 93061 0272 Stocklon,CA 95215 TEL:(559)734 9473 <br /> TEL (805)392-2000 TEL: (20s))9420181 Mobile'.(559)7372399 <br /> r- FAX: (005)525-4172 FAX: (209)942-0423 FAX:(559)734-8435 <br />