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CHAIN-OF-CUSTODY RECORD •� OAK 118 5 8 It'S?sS ` <br /> PROJECT NAME: �/ DATE: PAGE 2, OF 2, t` <br /> 0 <br /> LAB RATORY NAME: CLIENT INFORMATION: REPORTING REQUI E T : O <br /> PROJECT NUMBER: N <br /> t � <br /> LABORATORY ADDRESS: 0) <br /> RESULTS TO: <br /> rI <br /> TURNAROUND TIME: CA \ <br /> Y '0 <br /> O <br /> SAMPLE SHIPMENT METHOD: L ATO ONTACT: GEOTRACKER REQUIRED YES NO <br /> LABO ATORY PHON NU ER: 10 <br /> (. CJ SITE SPECIFIC GLOBAL ID NO. <br /> SAMPLERS (SIGNATURE): ANALYSES <br /> 11 - �J <br /> f l_iVO 2 c <br /> 4/ <br /> � m o cu A <br /> _ 3 - m 0 o <br /> SAMPLE CONTAINER N' a) o ADDITIONAL <br /> DATE TIME NUMBER TYPE AND SIZE co LL a 0 i z° COMMENTS <br /> 10,12:0 <br /> (0 ---T-U , —s <br /> IPS —� s s© <br /> w <br /> o <br /> LO <br /> ro <br /> a <br /> m <br /> RELIN UISHED BY: DATE TIME RECEIVED BY: DATE TIME <br /> TOTAL NUMBER OF CONTAINERS: <br /> SI NAT R ( SI ATURE: �(12 SAMPLING COMMENTS: <br /> PR ` P T D NAME: �2 <br /> �Q,r;Q <br /> COMPANY: <br /> COMPAN��..^ �V �� .1S <br /> I SIGNATURE: SIGNATURE: <br /> PRINTED NAME: <br /> PRINTED NAME: <br /> COMPANY: <br /> COMPANY: <br /> SIGNATURE: SIGNATURE: 2101 Webster Street, 12th Floor <br /> PRINTED NAME: PRINTEDNAME: Oakland, California 94612-3066 Geomatrix <br /> COMPANY: Tel 510.663.4100 Fax 510.663.4141 <br /> COMPANY: <br />