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ASSOCIATED LA.BORATORIE� <br /> 806 North Batavia ■ Orclnye CA 92868 <br /> Chain of Custody Record <br /> Phone (714) 771-6900 Fax (714) 538-1209 ' <br /> Company / r L �- Pho �-6 �Z.� J��J�'/ A L Job No � �[ Page of <br /> Project Ntanager � Nt 1 a ��Z �2,r- •�{� Analysis Requested Test Instructions &Comments <br /> Project Name p �- Protect q y 2- <br /> ----------------- <br /> Site <br /> and Name 94 <br /> Address r� <br /> c�, .7-vr�,/��,, ? C� G��`�G� � f <br /> !f C /Y ✓ Container <br /> Sample ID Lab ID Date Time Matrix Number/Size Pres <br /> T kg <br /> 2 n2_ d.20 L i2 I SD l-Ap— Wdwr, X <br /> 4 <br /> 5 <br /> 6 <br /> 9 / <br /> 1p <br /> ,t <br /> 12 <br /> 13 <br /> 14 <br /> 15 <br /> Relinquished by i R0 inqulshed qy 2 Relinquished by 3 <br /> Sample Receipt-To Be Filled By Laboratory Sam lei -+2gf�`if GvL � <br /> Signature Signature Signature <br /> Total Number of Containers Properly Cooled Y/N/NA �� <br /> Printed Name Printed Name <br /> Panted Name <br /> Custody Seals Y I N!NA �(� Samples Intact Y!N/NA of `� <br /> Date Ttme / Date Time Date Time <br /> Received m Goad Condition Y 1 N Samples Accepted Y/N ,14 i,�� aZ /� <br /> Receive 1 Received B Received By 3 <br /> Turn Around Time & 7z <br /> Signature Signature Signature ' <br /> ��Ll Normal <br /> Day ❑48 hrs Printed Name Printed Name ��^ Printed Name <br /> (� Normal ❑ Rush 24�„� ❑72 hrs <br /> Date Time Date r Time r f� Date Time <br /> DistnbAtpn White Laboratory Canary Laboratory Pink Proteci/Aceount Manager Goldenrod Sampler/Originatar — <br />