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6602 Owens Drive, Suite 100 <br /> Pleasanton, CA 94588 CHAIN OF CUSTODY FORM <br /> Main Line (925) 460-5300 <br /> Protect Name <br /> A 5 9 0 C , A T E 9 1 N C Facsimile (925)463-2559 Turnaround 10 day 3 day 2-s hr <br /> A0TEC,A Client Project Number Time 7 da _2 da <br /> Project Address <br /> 9 n —1 Task _ �� (working days) —5 day —24 hr —other ) <br /> Laboratory Contact <br /> Lab Address/Phone �a Analyses Requested <br /> ATC Project Manager d N � <br /> ATC PM Ph No (925) 225- Email <br /> ATC Sampler � /''jlC�t�-�'tirMatc-enviro com o N <br /> P i �: Ar;( K Phone (925)225- -79'31 M <br /> W <br /> CID <br /> Sample Information Container Information H Lo <br /> m n w o <br /> C O w H p <br /> Matrix m Co N O0 CID „ a; <br /> NO Type 0 Comments 1 o p �j �j m c <br /> ATC Sample ID Date Time soli Water vapor ' Field Notes 10, W LL (L = j O a v <br /> -K UJB <br /> H0:)o <br /> oZS -oa7 <br /> —oo <br /> Additional Comments <br /> Relinquished 8y DateCfime / / .air Received B <br /> Relinquished By y Date/Time (t I� sl t c s <br /> % Date/Time Received By Date/Time <br /> Relinquished By DatelTime Received By Date/Time <br /> Sample Condition Good? Yes No On ice? Yes_No` Cooler Temp Transportalion Method <br /> Pa of <br /> — cj ,_,n) 1,11IGI—rdl vnedc M1,qy casenO5n60, Yellow- - Lab Pink - nTr <br />