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California Water Labs, Inc. <br /> P.O.BOX 4249 <br /> 1430 CARPENTER LAN E—SUITE G - <br /> =- MODESTO,CA 95352 <br /> c PHONE(209)527-4050 <br /> c <br /> CHAIN OF CUSTODY RECORD <br /> PROJECT NAME: <br /> \S PLER$ (signature) <br /> \ Number 4F <br /> e of REMARKS <br /> Station <br /> Number to Time b Station Location Con <br /> tainers � <br /> i�Ir.,1-1-33 - -4- <br /> .,t 77 <br /> . <br /> _TT <br /> inqu shed by(signature): Date / Time Received by (signature): Relinquished by(signature): Date / Time Received by (signature): <br /> ;;c ompan,or A enc : k Company or Agency: Company or Agency: Company or Agency.• <br /> '� <br /> Relinquished by(signature): Date / Time Received by (signature): Relinquished by: Date / Time Received by (signature): <br /> Company or Agency: Company or Agency:- Company or Agency: Company or Agency: <br /> Relinquished by(signature): Date / Time Received for Laboratory by: Date / Time Remarks/Shipping Information <br /> . . . Company or Agency: � (signature)� <br /> — L. <br />