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CHAIN OF CUSTODY RECORD SC Log Number <br /> Client name Project or POA' Analyses roqulred <br /> Address Phone R <br /> \`� <br /> City,Slato,Zip Report attention a <br /> Sampled by <br /> Lob �-. Number <br /> Sample DAte Time Soo"y of <br /> numboi samplod sampled below Sampledeacrlpllon' comalners -z' <br /> y Remarks <br /> ITJ <br /> W <br /> G <br /> N <br /> N <br /> Pa <br /> `C7 <br /> CD <br /> n <br /> I _ <br /> 0 <br /> a <br /> Slgnnlur* Print Name Company Dot* T, <br /> 09 Rolingvlshed by <br /> C1 <br /> O. Received by <br /> Rollnqulshod by <br /> Rocolvod by <br /> R*Ilnqulshed <br /> Rocolvod by Loboralory <br /> BROWN AND CALDWELL LACOFIAT0R(ES Note: <br /> C3 1255 Powell Sirool,Emoryv1110,CA 94609 (0$)429.2000 Samples are dlseerdod 3o deye aper results are roponod unless other arrangomenls are made. <br /> ❑ 170 South Fnlr Oeks Avvnuo,Pnsadana,CA 91105 (916)745.7550 Fiatardous samples wilt be returned to client or dlsposod of at ctlonl ezpomse. <br /> ❑ 1200 Poe ico Avonuo,Annholm,CA 9205 . 'KEY: AO—Aquoous NA—Nonequoous SL--Sludge OW—Oronndwoior SO—Solt OT-01hor PE—Peiroloum <br /> 4 <br />