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_ s T <br /> SPARGr:TECHNOLOGY, INC. A3 C ;CHAIN OF CUSTODY RECORD ' <br /> Analytical Laboratory Phone:(9 16)362-8947 C.O.0 No. 0105 <br /> 3050 Fite Circle,#112 Sacramento,CA 95827 FAX:(916)362-0947 Page of Z- STAL Invoice Number: <br /> Company: A(O--( Ff77v'1�f� Phone: ANALYSIS REQUEST <br /> Project Manager: J L +�yFAX: REMARKS: Sampler's Name: <br /> Report Address: Billing Name&Address: <br /> All None Some <br /> Project Name: �(,,� �k �Project/Job#: OK OK OK WET STLC <br /> ✓ y,( Cooler Temp. °C <br /> Project Location: f�N P.O.#: f}o2.o by Sample Condition TCLP <br /> J pH <br /> Preservative TCLP Total <br /> Sampling Container Used Matrix TAT <br /> N <br /> co <br /> V L <br /> ,C <br /> Q <br /> C <br /> U LL! a N d <br /> Q .0 co m K) - N <br /> Q N p] a <br /> ca <br /> ` ? <br /> NO. SAMPLE ID Date Time J v o - o 5 o <br /> dam' m N O m Z C: (n Q Cr w o: <br /> 2 Mw- Pt -- `Co � <br /> 3 — 5 <br /> 4 - to <br /> 6 <br /> 7 tiiv <br /> 8 M�,-a t <br /> 9w- do <br /> 10 1I, <br /> Relin ished Receiv_ Relinquished by: Received by: <br /> /D• <br /> Date: Time: Date:i -a 9 P Time:r�: � Date: Time: Date: Time: <br /> PLEASE READ REVERSE SIDE FOR TERMS AND CONDITIONS <br />