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LogBSK Nu- 1 � MNALC$ RETIC OFODORLFM k <br /> Client Name Project or PO N Analysis required I <br /> Lab Use Only <br /> Address P ne i't in this <br /> UQr� ZD �. T d section <br /> City,State Report attention ly .0 <br /> X�Gr��raH tr Q F�.�� <br /> Sampled bSample <br /> Sam le r Agra <br /> Number Lab <br /> Dale Time T1�_ ✓ rL�e of Sample teals <br /> sampled sampled See lc Sample description ntainers number ('fieY Z y <br /> below) below} Remarks <br /> y3 3 v 03 �lD 7o�T` o 1 ,PX <br /> 2 41 <br /> Z o l ( Z' X x <br /> k <br /> e �o <br /> ms's �s�f x <br /> X <br /> IMPORTANT NOTICE No samples will be analyzed without an authorized signature in this section <br /> I am hereby requesting BSK s Normal Chain-of-CustodyProcedures for the above samples I understand that I am hereby requesting BSK s Formal Chain-0f-Custody Procedures for the above samples.t understand that <br /> these procedures are generally consistent with those outlined in the U S E PA SW 846 and that there is no these procedures are generally consistent with those outlined m U S EPA Contract Laboratory Program State <br /> extra charge for this service ment of Work Section F and that there is a charge of$500 per work order or 55.00 a bottle,whichever is <br /> • greater <br /> By By Authorized Signature <br /> Authorized Signature <br /> Print Name Company Date Time <br /> Signature P <br /> Relinquished by T!N rU 3 0d <br /> Received by V UL <br /> Relinquished by <br /> I <br /> Recanted by <br /> Relinquished by <br /> Aece+ved by <br /> KEY Type AQ-Aqueous SL-Sludge SO--Soil PE-Petroleum CYT-Other <br /> [`�� Seals P-Present A-Absent B-13roken <br /> _ ' <br /> J & Associates Chemical Laboratories DISTRIBUTION WHITE CANARY-LABORMORY PINK ORIGINATOR <br /> Note <br /> 1414 Starnslaus Street Fresno, California 93706 Samples are discarded 14 days after results are reported unless other arrangements are made. <br /> Hazardous samples will be returned to client or disposed of at client expense. <br /> Telephone (209)485-8310 9 Fax (209) 485-7427 <br />