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w r r� w r r � r ■� r ■� w � �� i� <br /> Claytoff <br /> CHAIN OF CUSTODY 95-2-2:'(0�7 Page of <br /> � <br /> C:z) t~.k0ur SIRVILIS �J Lab STL <br /> TAT 5 day <br /> Report results to <br /> Name Mal Reimer Project Information <br /> Company Clayton Group Services Protect No. 80-02263 00 200 <br /> Mailing Address 6920 Koll Center Parkway:Ste 216 Name The Learner Company <br /> City, State, Zip Pleasanton, Califomia 94566 Location 2711 Navy Drive, Stockton, CA <br /> _Telephone No 1825)426-2600 <br /> Fax No - (9251426-0106 Anal ses Requested <br /> i <br /> X m <br /> Spectal instructions and/or speafic replalory requiremena ts m <br /> I � <br /> UJca <br /> oC <br /> EL rn <br /> G .r m QS <br /> Lo <br /> O O tv m <br /> Date Time Matrix/ No of Q < < Sample Conddion/Comments <br /> Sample Identification Sam lad °Sampled Media 0onts, w gar w <br /> MW-1 tt l3 03 i l;50 GW $ X X X <br /> MW-2 10010 0 i2'`io GW ' X X X <br /> MW-3 a t3 4) 11-50 GW $ X X X <br /> 4 <br /> Collected by Dare/Tlma Collector's Signature DatelTlme <br /> Relinquished by DateMme it 1-5,C0 Received by Datemme <br /> Relinquished by DatelTrme Received byD� D bF Date?ime <br /> Method of Shipment Sample Condition on Rcpt <br /> � I <br />