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KAPREAIIAN ENGINEERING <br /> I N C O R P O R A T E D <br /> CHAIN OF CUSTODY <br /> SAMPLER q SITE NAME d ADDRESS ANALYSES REQUESTED TURN AROUND TIME: <br /> �O �c Vv�OCak / Lo1 <br /> WITNESSING AGENCY � aI � , �e �le V--,a 0 o <br /> NO. ti <br /> u D <br /> SAMPLE OF SAMPLING v R E M A R K S <br /> ID NO. DATE TIME SOIL WAT GRAB COMP CONT. LOCATION /,, <br /> ►N1 W- 1% 10:0,0 r✓ J lM ✓ <br /> C �D v l{J <br /> �q <br /> 0A W- <br /> MW- 10 30 <br /> Relinquished by: (Signature) Da a/Time R c iv y: (Si ture) The following MUST BE completed by the laboratory accepting samples <br /> �7. U� 2-/q -a.� for analysis: <br /> 1. Have all samples received fora sis been stored in ice? <br /> Relinquished by; (Signature) Date/Time Received by: (Signal <br /> ,Q) Z. Wit( samptes remain refrigerate ntil analyzed? <br /> Relinquished by: (Signature) Date/Time Received by: (Signature) 3. 0id'any samples received for a sis hav ead space? <br /> OC. <br /> 4, dere samples in appropriate contAi6ers and properly packaged? <br /> Relinquished by: (Signature) Date/Time Received by: (Signature) <br /> Signa ure Ti le Date <br /> 2401 5)anwell[)rive.Suke 400 <br /> Ctmeord.California 94520 <br /> TVI:51U.602.5100 F.1X:SR)GH7.0(0)Z <br />