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[ [ C L C C C [ C [ [ C [ [ [ C [ L C <br /> . o <br /> EARTH TREATTREATMENI SYSTEMS <br /> ENVIRONMENTAL CONSULTANTS ' <br /> CHAIN OF CUSTODY RECO "d <br /> PROJECT NAME: <br /> Number of �yti a <br /> SAMPLER (signature) : IQ; <br /> � n ItD�� 1,J Container a/ <br /> D <br /> N Type of <br /> Date Time Sample Location Sample <br /> Lab I.D. <br /> E-Zl Sb n'.Zoi <br /> 5.3S Pmn 3r,1 -o(62 155--1 x <br /> +( <br /> I. C-"r\ 301 - U(,,-1I S I - 1'S x F p�-7(Q 0 <br /> o_3bnm 0 -06z158 AP-LL5? - 1 <br /> ., ro x�•Y. 57,.. 3..it',:? ' 1i <br /> :loan. -W z1255 -3- Y, 577 - <br /> 1, 12: 0, — t.. �21 , 2 <br /> EE U 5 <br /> Relinquishby: Date / Time Received by: Relinquished by: Date / Time eceived by: <br /> -L Gvt— j 41y,(/ I <br /> Company: Com any: ETS Company: � Com an <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 /> Com an : Company Company: Company: <br /> NOTE: In preparing legal documents always use ink and signatures <br /> 1P_n gray 094z (ono) 3R4-1041 MIERCFn CA Qs-4n <br />