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r L` <br /> CHAIN-OF-CUSTODY RECORD AND ANALYSIS REQUEST <br /> PROD.NO. PROJECT NAME <br /> 603X7- r� E <br /> 11_0_SANALYSIS TYPE REQUESTED 5i <br /> SAMPLERS 1Slynature) <br /> � w <br /> w <br /> IL Z <br /> I.D.NO. DATE Till 2 STATION&LOCATION V <br /> CIM /71f r No REMARKS <br /> I . aafS � f <br /> �. 9/ ,3� as► o�?h+ 1- s X <br /> A r L-4--pig - S u7'H W ImLinr Ttre b, 1 <br /> X x <br /> Y' T 1 c.urz 5 �� <br /> . 7 1 !/r} �i-it a a�' 1�✓ r7 � 1 '•/� � S � x <br /> I <br /> i <br /> PLEASERETURN IGE CNE$TS <br /> AND BLUE ICE TO WhTERMRK <br /> Y <br /> uB <br /> Relinquished by: Time JG- 4 `AQ. WW PRgj MGR, <br /> Date Received by <br /> Relinquished by: Date Time Received <br /> /736 y= �i_vz�.�01 <br /> Relinquished by Data <br /> Time Received y: <br /> • bRelinqulahed by-; Date Tlma Received by; � 9i <br /> Relinquished by: Date Time Received by Laboratory: <br /> Date Time I! <br /> REMARKS(Shipping Related): <br /> Z <br /> 1710 MAIN STREET • ESCALON,CA 95320 s � <br /> (209)638-3507 <br /> i <br />