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g Number <br /> CHAIN OF CUSTODY RECORD A:� �k'� BCA Lok <br /> It <br /> rorty Project or PON vAnalyses required <br /> 30-? s�Y <br /> Add•at t 1 (7 Z y(�S Phot 37OY, L—�jt� ��� •� 0 • <br /> o <br /> City,St/a1�e,Zip /�u Rep/ort�ttention X N `00 <br /> G� \ 23 W e F� • t� ,"1 4 aFQc�' C <br /> P Y <br /> \ 5a <br /> Lab Type* Sampled CC C'L-- Number <br /> Sample Date 'Time See key of `V rQ, �1p tia0c?° <br /> number sampled sampled below Sample description containers 1J Q �aSQ Remarks <br /> 3 f69� I .Aa, eRMj0 -TQ9QC 9003M31 2- <br /> I <br /> I;gU�C�C �OU31613.Z � V <br /> S C�,/ 003 I 6 Z--- 7— <br /> S T C_ <br /> - <br /> SC 2 9 0316 1 ZiS 2-- <br /> S c�c 3 Goo3I6 I Z- Z <br /> 0031lL 130 2-- <br /> 90 <br /> 0 03 SS H v V <br /> P(66 6 2 90 03 y FSS z " <br /> P(KS 43 q0Q31 <br /> 3 1 as Pal Lq1 002Iq 16o I ✓ <br /> t <br /> Signature / Print Name Company Date Time <br /> Relinquished by f7Ar� I r1 • O� f RM UP _31146 G 2_U 1 P <br /> Received by �N��CC ►�✓�"`���\ <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by L orator <br /> B C ANALYTI Note:Samples are discarded 30 days after results are reported unless other arrangements are made. 'KEY: AQ—Aqueous NA—Nonaqueous SL—Sludge <br /> Hazardous samples will be returned to client or disposed of at client's expense. GW—Groundwater SO—Soil OT—Other PE—Petroleum. <br /> C 1255 Powell Street,Em yville,CA 94608 (415)428-2300 s " <br /> 111801 Western Avenue,Glendale,CA 91201 (818)247-5737 Disposal arrangements: yyx. <br /> �J 1200 Pacifico Avenue,Anaheim,CA 92805 (714)978-0113 <br />