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-,NTS EARTH TREATMENT SYSTEMS <br /> ENVIRONMENTAL CONSULTANTS ' <br /> CHAIN OF CUSTODY RECO "d <br /> PROJECT NAME : <br /> 301 <br /> SAMPLER (signature) ; Number of � y�� <br /> Containers/ � a <br /> Type of <br /> L � <br /> )ate Time Sample Location Sample \ ,� <br /> Lab I.D. <br /> y 1 30Ufv1lC1�s II7 ` I-S t. I, x <br /> b:36 rn Lol -06zi 58 A ' t1 �7 � <br /> , <br /> �I Zlas —3 - , _ , 1c P* 5�� �- <br /> (z: ,tom CQ 5� <br /> L "mom 1 21 :�If, r X <br /> Relinquishby: Date / Time Received by: Relinquished by : Date / Time eceived by: <br /> C-- /Y') S <br /> Company: Company: �3 Company: � Company <br /> Relinquished by: Date / Time Received by: Relinquished by: Date / Time Received by: <br /> Com an : Company: Company : Company: <br /> Relinquished by : Date Time Received by: Relinquished by : Date Time Received by : <br /> ----------- <br /> Company: Com any Com an : Com an : <br /> NOTE: In preparing legal documents always use ink and signatures <br /> InAl MFRrr:n r.A a4o <br />