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I <br /> CHAIN OF CUSTODY RECORD BCA Lag Number <br /> i <br /> Client name Project or POM <br /> kI-ely�� 041, bu,j 1Analyses required <br /> I'l "T <br /> Address Phone K4z7z rV <br /> 961& Miaucm ASE rTiY-Ilk 600 ,7r 94-01z,--:,. <br /> Cit Slate Zip Report <br /> tte Iron \ o <br /> Op, <br /> �$ZS,__,n <br /> Lab Type Sampled by y�/e��� �cQ' <br /> krry1rj f 1 TrII6iJ�t1R Number <br /> Sample tate Time See key of <br /> number sampled sampled below Sample description Containers /Q� Z�r�}' Remarks <br /> I �9 Icof Cr Itis M N-t <br /> M) WIVIF <br /> 3 �1 <br /> +�%-3 r -;� z <br /> V. <br /> I � <br /> I <br /> I <br /> i <br /> / <br /> C;jbnaty4 Print Name Company Date Time <br /> Relinquished by F ~7 t <br /> —� 01010 <br /> Received by / <br /> / y � <br /> Rehnquishec� We/ <br /> yr. ✓ d <br /> Received by ` <br /> Relinquished by <br /> i <br /> Received by Laboratory <br /> B C ANALYTICAL Note Samples are discarded 30 days after results are reported unless other arrangements are made 'KEY AG—Aqueous NA—Nonaqueous SL—Sludge <br /> [ 1 5085 Shary C'irrl( Concord Ln 11 1518 1510,825 3894 <br /> Hazardous samples will be returned to client or disposed of at client s expense GW—Groundwater SO—Soil PE--Pelroleum <br /> 0 801 Western Ave n (',Iendal- ('A 91201 (818)247 5737 Disposal arrangements <br /> f_1 12d0 Gine Au 1 Anali�,irn CA 112805(71 1)978 0113 • <br /> ti <br />