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CHAIN OF CUSTODY No•. 118 6 8 2 <br /> CONSULTANTS NAME CONS ULIAN I'S ADDRESS <br /> Services. In 1680 Ra ers Ade San lose C11 5112 <br /> BP 51— T�ENUMMBER . BP SITE/FACILITY ADDRESS CONSULIANI PROJECI IJUMBEfI <br /> _11195 - o� <br /> CONSULTANT PROJECT MANGEr1 IIONE NUM6ER SAX IIUMdEII COIISUI_fAlll ('0111IIACI HIRAlllclr <br /> s 408 5.73-0555 X218 (408)573-7771 <br /> BP CONT CT BP AbbRE55 PHONE NUMBE11 -AX Ito. <br /> Scott Hooton 295 SW Gls-L SL._, Renton -WA _LF25)251--0689 CG25�Z51�U.736__-___.___T <br /> LAB CON[Ac r LABORATORY AD411E55 PI IONE NUMBErI FAX NO. <br /> SP - Sord-a WesU P.0, Sax 20807 HousL-on ']. 800 9694775 <br /> BP CONTACT REQUESTING RUSI-I TAT(Print 13P Conlacl NBrne) RUS[I REQUESTED OF IPrinl Consullanl Conlacl Name) DAIEIIIME SI IIPMENT DATE SI IIPMENI ME I I IOU <br /> � A11113111ITUMOFn <br /> TAT: ❑ 24 Hours U 4B[lours ❑ 72 Hours rj�taTlOard 7 or 14 bays ANALYSIS REOUIRI D <br /> C0[Nemis PIIESEIIVAIIVE <br /> COLLE011011 COLLECI1011 MAIIIIX COMMEN I S <br /> SAMPLE DESCRIPTION DAIE TIME SOIL NAIER NO "TYPE LA13 .14 QUA Q <br /> (VOL.) SAMPLE <br /> 3 2z-If ly,•is W yba. X <br /> S-ss. g W ---- — — -- <br /> 3-27-•- /V.'sS w 3 <br /> 3- 2s- IS::o W 3 <br /> s-2-z~ 1!C so r�, — <br /> � <br /> Id 3 <br /> SAMPLED BY(Please Prin1 Name) SAMPLED B (5lgnalure AUDI I IONAL COMMEH I S <br /> & xR— <br /> RELINQUISHED BY/AFFILIA1lON DAIE TIME 07 ACCEPT EU13YIAFFILIAIION DAIE 11MF <br /> of (Print Nalne 15lgnalure) (Print Name 1 Slgnaluiel <br /> �d /5370 <br /> x" <br /> Z % Oct <br /> CLV-Ierxx A 18feT) <br /> rl<Busa DIS I r11BUnoN• wnu E-01-1101t IAL JW1II I DAIA? YELLOW.BP PINK-LAB BLUE•CCHSULIAM REI-D swr <br />