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9 i <br /> ff 5U ✓1 0 e I of <br /> ©ate �i 3�f�iNe ether � y� Page—_ -- �_ <br /> ERM-West Chain of Custody "Record <br /> 1777 Botelho Drive • Suite 260 • Walnut Creek.CA e 94596 (415)946-0455 <br /> Job# (572_V I Collection GC GC/MS org Other Remarks <br /> E <br /> Job Location �)tv c, <br /> Sampler(signature) L J S � <br /> N <br /> Printed name w N La <br /> Lab Report Recipient u�, _ `P U v_, U m (L N <br /> Telephone No 5`Z v - `7�{IG-O�{ o 1 o 5 ° y 9 °a CS v 4 <br /> Receiving Lab ar m is° a° saCOD r : N g L eV z - <br /> a . a. m o <br /> Address rn o N v to m L <br /> to Go Co GU 4ZOL <br /> Co w N N Cco EL 0 N V <br /> ro <br /> c%i IN <br /> w=water C=comp Volume U 11 U) H o3 m _t to w S z <br /> Sample ID# Time s=soil G rob �(PC)d�C� <br /> Mw -3A - 1 11 U 3 3Ec`f�.�1 1c,I YV - d <br /> M W 3A Z � ,i,,.l (ala 5 43 <br /> - y �r55 a <br /> MW -4A- t JbD ;l 1 x 1. Q <br /> M\AJ-4A-3 <br /> ,�,� �lGrti� Y _ - z ►�C,kt VcA �jCi!Z¢✓ r4 ilk 1 ( <br /> MEF <br /> AD ml q <br /> Precautions Cone ElLo0 Med 0 Ht Ship Via Total Number of Containers <br /> 15 <br /> Sample Relinquished By Date Time eceived By Date Time Reason for Transfer(List Shipping Bill Number) <br /> 6 1 fZ 1!= -0 <br /> tom any omy _ ~ <br /> AKA-We5t pany <br /> company dompany <br /> LABORATORY— <br /> Samples mp es mp es N o containers ontamer tags tat sea s <br /> please ComaletT intact at 4`C not leaking matches C al C r — match C of C — — intact — — <br /> �b sample custodian Signature— r mate mime ISBmpla o sposillon [� Retum to Site 0 Discard Q bold —days <br /> 2 21 09 DA <br /> L — -- — — — — — — _.... _... — — — — — — <br />