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KAFREALIAN ENGINEERING _ t <br /> I N C 0 R P 0 R A T E U <br /> CHAIN OF CUSTODY <br /> SAMPLER SITE NA1MEADDRESS ANALYSES REQUESTED TURN AROUND TIME <br /> ���`StaC <br /> WITNESSING AGENCY 1� 1 �v J (�) <br /> (- <br /> SAMPLE Of SAMPLING � M 11 E N A p X S <br /> ID NO DATE TIME SOIL WATER GRAB COMP CONT LOCATION <br /> w A-R Th 0h 4�w C,0 �,Z 1, <br /> 5w�-C ✓ ✓ 1 ✓ ✓ �/ g <br /> V,- L/ I \V <br /> Rei ( i a D e/Time eceived by (St atur ) The following MUST BE completed by the laboratory accepting samples <br /> 'l 0,>' for analysis <br /> 1 Have all same received for analysis been stored in ice? <br /> Relinquish (Signature ate/Timis R teiv by (Signature) <br /> 2 Will samples embin refrigerated until analyzed? <br /> r <br /> Relinquished by (Signature) Date/Time Received by (Signature) 3 Did any samps received for analysts have head space? i <br /> 4 Were samples in a ropriate containers and properly packaged? <br /> inquished by- (Signature) Date/Time Received by (Signature) ti <br /> ture Title Date <br /> I <br /> 2401 Stanwell l)rivL,Suite 400 <br /> CA)ncord C41ifornia 945211 <br /> ?L1 S1UfA1151U11 I ix il11{,H7fxAl2 <br /> 4 <br /> i <br />