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Advanced CHAIN OF CUSTODY RECORD <br /> _ c'C <br /> (_a LCQl;il Vli vi2111C111c11, 1IIC Date��' __— Page —_�of <br /> 4005 North Wilson Wjy-Slockicn,Caldpnu.r-95205-(209)467-1006-fax(209)447-1116 /5S 1 <br /> r <br /> Client �` Prolectlrlanager <br /> Tpsts Required <br /> Phone Number <br /> -R!B <br /> Sers (Signature) <br /> Irlsrolce � <br /> r <br /> pProlecl Name AGS <br /> ,� Client <br /> Lvirn l ' }-� C �� <br /> - <br /> 1 <br /> _ LacaUals _ <br /> Sal Type <br /> Sample ----- a o �� �'� �'�-6 <br /> Date Time Water Solid Nf � �r�t. <br /> Number Description -Comp Gram Alf— ConlsMR <br /> J4 <br /> Pit <br /> 4=_ jj <br /> ��rQ► �`? i; �( r �� . 2 - _ ( — - �t rev ,� <br /> 1 f 0 7a' • <br /> #'tg -25 z5_ - V:3 0 <br /> at„ <br /> T Cr <br /> fi Ul <br /> UatelZlnte <br /> o nQuis is �y� iynu r e f�occ v �y ry-- r � SA `1 .P <br /> Avn- nofSekluqurs a by (Sved by (S Ey nal re) r r 1 <br /> A4 Wi,P-s� CA- BOAS 8G �, 01 <br /> Helrnquis t by (Srgnalure? Hecelved by Pdabdo Laboralory lur hold analysis (Si9rratu141) GOOD <br /> r0MMON <br /> FRISIRVATION <br /> (113palcbed by (Slgnalute) OalelTlm6 Ilecerved lot Laboretrsry D8PAGE�S �O�1�Alti�� UalelThne <br /> IIChadof Shipment r Laboratory Plums � <br /> 4N 1 <br /> �peeLllnslrucbons ^^�� I hViGbyy�AU11101Ite 1116 performencs 01 the above Indicated Nock q� <br /> JL I <br /> •c 4 r - — <br /> i <br />