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Upgradient Consultants <br /> Subcontracted Microbiology Assays <br /> performed by <br /> Cyt0CUJtr'Jre Environmental Biotechnology <br /> CHAIN OF CUSTODY FORM <br /> Project Name Project No Upgrad tent Consultants Purchase Order/ LOG IN # <br /> Upgr3l"tma Consultaa^ts Client OrgaMI-Mtloa kradaent CunsultanLs Project Manager <br /> I Address to Send 1?esuhs <br /> Client Fax for Sending DataClient Contact/Project Manager <br /> Z09 77 _36 � o <br /> C tent cl for allow-sip Client Sampler/Recorder .� <br /> Sample I D Sampling matrix Analyses Requested <br /> Ind:tate target Date Time Soil Water hydrocarbon Total plc DO NH, PO, NO, SO, Other Tests or <br /> Hydrocarbon range Degrading Heterotrophic Comments <br /> Bacteria Plate Bacteria Plate <br /> Count Count <br /> V c5 <br /> v — Z <br /> i <br /> )f I`` --3 <br /> Cbm of Custody Record Signature of this form constitutes a firm Pu-chase Order for services Payment DDE on Reporting Date <br /> 1 Ff v�tnnaaT't•�r� ��s. 1 il..M/CIv .—.1-,7�_ J 1 -,�.�,.•,.-•.•.••�,.,,,,� —,..� <br /> Dateir <br /> Received for -,s CWture Lab b Date/Hr C ,aC dire Tel 514-233- r <br /> y y 0142 Please fax Cham of Custody form <br /> v <br /> 51 �l � Lab Services Fax 510-233-3777 to CytoCulture pnor to delivery. <br />