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K KAPAEALIAN ENGINEERINGo INC. <br /> CHAIN OF CUSTODY <br /> 'SAMPLER I SITE NAME L ADDRESSI ANALYSES RE4ilESTED I TURN AROUND TIME: ! <br /> I I Uxoe-a l 4 ad,' e ccs I <br /> IwITNESSING AGENCY <br /> I I fel I i I I i I 1 <br /> •,- 1�T i I I I I I k <br /> NO. <br /> I <br /> I WLE ' I 1 I I 1 I OF ! SAMPLING I a-1 I I I I I ! R E M A z C s I <br /> I ID NO. I DATE I TIME I SOIL IWTERIGRADICOMPICOMT.1 LOCATIbN <br /> I � I Ij Z ,I Imo! I IJcee ,sd <br /> I I I I ✓I I mo! 1 I I I 1 I I I I I �j'g� I <br /> I <br /> ! gel y I 1V I Ivl I I IVI 1 I I I 1 i ! � 9 I <br /> I <br /> IllZro© a <br /> IMw _ I r, I 1 I ISI I 1 �1 I k I I 1 I <br /> loot I <br /> T I <br /> I � _ y rr I f ✓ f I �I f 1 f I v! I ! I ! I I � d d � I <br /> I Sal I Iv f I I I 1 Ivl I f I I I ! 1003 I <br /> I Mws tr I I `� I I of I I I 1 I I I I f <br /> 100 <br /> w _ ko l a I I ✓ I 1 v1 f f 1 ✓ <br /> IRel1Ished by: ( ignat e) I Date/Time I Recel-ed by: (5i to I The fottowing MUST BE completed by the leboratory accepting sa,pleS I <br /> I/ / I 7 I for analysis: <br /> 1. Have stl samples received analysis been stored in ice? ' <br /> IletinWished by: (Signature) I Date/Time I Race:.• f by: (Signature) I I <br /> I I 12. kilt samples remain re ,gersted until w4tyted? I <br /> IRetimcpished by: (Signature) I Date/Time I Rece: - J br: (Signature) 13. Did any sa+ples received for analysis have head space? I <br /> I I I I r, I <br /> 4. were samples in a r ate containers and properly packaged? I <br /> IRelingjished by: (Signature) I Date/Time I Rece. by: (Signature) I 1 <br /> I I I I ,gnecure Title tc I <br />