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c <br /> BILL TO LA:54 O 5 <br /> �`T�Q # <br /> • 8084 OLD AUBURN ROAD GHH CONSTRUCTION <br /> ❑ GrTRUS HE3GHTS, CA 95810 SERVICES, INC <br /> �� (9iel 723-m8 ❑ LTC #608406 JOB t.�OS�tS <br /> /.�- :.;.' LSC #806360 easa OLD AUBURN �onD crraus kElCHT3 rn aseio <br />' CHAIN OF CUSTODY P0 # <br /> JOB NAME � _ LAB <br /> f , <br /> PROJECT MANAGER � ll 'l SAMPLES COLLECTED BY �Q4S <br /> 1o SAMPLE TYPE <br /> SAMPLE TYPE ANALYSIS SAMPLE LOCATION DATE TIME NO CONTAINER(S) REQUIRED <br /> SOIL AIR WATER <br /> 7 �� �` I l�S � 4.1-S 3 voA► � t <br /> X l 2 <br /> UL x1 3GO - 1 3xvoA +rte <br /> I a2'4 <br /> eQUISHE15 <br /> AFTER SIGNATURE <br /> A RECEIVED BY DATE/TIME <br />:RELIBY RECEIVED BY DATE/'IIME <br /> RELINQUISHED BY RECEIVED BY DATE/TIME <br /> RECEIVED FOR LABORATORY BY DATE/TIME <br /> METHOD OF SHIPMENT CP <br />' DISPOSITION <br /> STORAGE ❑ REFRIGERATOR ❑ FREEZER <br />,*RN AROUND TIME SECURED <br /> ❑ 24 HOURS ❑ 3 DAYS ❑ 1 WEEK2 WEEKS ❑ 1:1YES NO <br /> NOTE PLFASF HAVE FACI•I DATA SHEET SIGNED BY HF MIST <br />