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n <br /> North State Environmental Analytical Laboratory q7 - 5a <br /> Chain of Custody/Request for Analysis (415)588-9652 <br /> Client: Phone: Report to: Turnaround Time <br /> kZ,mnc,�S�ivIC c� -4��7�72--033 I�ikZ, �i,,� �Sc-vvtCc7 r-U,-A 6yVZ4 e_:Vcc rOL <br /> Mailing Address: RXV7Z J i 7 34 $filling to: 8 Hr 24 Hr <br /> =�lG,I SCvt2td HLZ,.�1c./S�jC1 <br /> [? St 11 Vreet 11s I L.es1i� St+r~ee1- <br /> S�tn w�tce, t QL(p Z w—Je- i cA 9z44o Z <br /> 40 Hr 5 Da <br /> Site Address: I t '3 1 K011 y T>r i ve. •Tv-nc\/, CA PO# / Billing Reference: ri <br /> Sampler: ,, Date: 17(0— 1 5 ' I Other <br /> ?'BAR-k. ,q <br /> Sample ID: Sample Description Container Sampling _ <br /> # / type Time/Date TPH-D TPH-G BTEX O+G Remarks <br /> SFbIL-7-4; PLEME <br /> I <br /> lz�5 S <br /> 2 oz.- AeS <br /> �I cz VCi c 3k i's <br /> e57. <br /> Relinquished by: g, lime:' Received by: 14/1461,G Yes No <br /> Relinquished by: ate: Time: Received by: Were samples <br /> Preserved ? <br /> Relinquished by: Date: Time: Received in lab by: In good <br /> condition <br />