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PLEASE RETURN ORIGINAL <br /> LAWRENCE&AssociaTEs CHAIN-OF-CUSTODY FORM ANALYSIS REQUESTED o <br /> 3590 Iron Ct. 0 m <br /> Shasta LakeD lf ,CA 96019 y <br /> s LAIR RI3NCF (530)275-4500 0 <br /> o <br /> -ASSOCIATES fax:(530)275-7970 0 � (^� `,�� I tZ 3 O y LABORATORY S�, r C, ,G CD <br /> o PROJECT IGlYri9 Pei+ - R1122 4)oQ "c s. c- - <br /> o ? CD <br /> JOB NUMBER D I Ct 101164- lteC�-�t�l� , ( �j�© O 0 <br /> C) < o <br /> D o CONTACT <br /> r <br /> \ o <br /> n y p v d N v_ <br /> MATRIX METHOD SAMPLE NUMBER SAMPLING DATE LABORATORY N O <br /> N <br /> 2 w PRESERVED I.D.# �"� <br /> pp g z w S <br /> N H L <br /> viwu <br /> c) <br /> -�wwn <br /> C <br /> Zo CD <br /> OO YEAR MO. DAY TIME <br /> Z <br /> D UTN;21 v ! TRl <br /> C. <br /> O O <br /> A0e <br /> _ Av) <br /> (41 <br /> 016 - 11 -171 (Q <br /> A = <br /> 09-1� � � � <br /> SHORT HO G TIME <br /> 08-1 -G > C Noe oP Ss °. <br /> X o o� -�• to AS COT <br /> 6 <br /> w� <br /> y COMMENTS AND NOTES C_ CHAIN OF CUSTODY RECORD <br /> coo a <br /> L&A GLOBAL ID# J ) L5 5 T 0,2,356 <br /> 00G A SITE ID# SA ED BY:(Signat )Date/Hour <br /> RELINQUISHED BY:(Signature) ate/Hour RECEIVED BY:(Signature)Date/Hour <br /> o o �.� r '117 C31�ilrl✓�- Iwr,n�..cA°M /� � �9- <br /> v s <br /> RELINQUISHED BY:(Signature)Date/Hour RECEIVED BY:(Sig ture) <br /> ° ' h t--D l=- <br /> AVO J1 750 <br /> RELINQUISHED (Signature)Date/Hour RECEIVED BY:(Signature) <br /> i) / o <br /> a 41-q-13 18,f' <br /> E <br /> c. DISPATC BY:(Signature)Date/Hour RECEIVED B :(Sig <br /> e) <br /> S 1 / <br /> PAGE�OF� BILL TO: L&A)f CLIENT[] L/ <br /> -c s <br /> i' <br /> m � <br /> 0 <br /> 91 <br /> (D <br /> W <br /> O_ <br /> W <br /> N <br />