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DELTA Sample Identification/Field Chain of Custom Record <br /> ENVIRONMENTAL CONSULTANTS, INC. <br /> ^. <br /> Project: ,J { I Cl I I — (_1 ra n� L 1. D I r':-(i�J, (_;c_ W.O. # <br /> Shipped by: "ice!n i ��C,;/�,N L A, riA <br /> Shipped to: Fc,�� %�t nl i_ u / C t3 i S i'Ci �-� Attention of: <br /> Comments: I Hazardous materials suspected?(Y9,5/no) <br /> Sampling Sample No.of Analysis <br /> Point Location / Field ID � Date Type Containers Required <br /> C/A 1 �flii -) J63-1 i ,�. I � j '_;,;„ y ;` f U 1 r <br /> 717 <br /> '513 2 <br /> Sampler(s)(signature) L <br /> Field ID Relinquish by:(signature) Received by:(signature) Date/Time Comments <br /> Sealed for shipment by: (signature) ( ' �' ` ` / f f Datef ime I ' '�" Shipment method: )' <br /> Received for Lab by: (signature) , �� l L �Cu Date/Time "=• Comments <br /> r <br /> Receiving Laboratory: Please return original form after signing for rocciipt of samples. <br />