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E n s e c o Page of� <br /> CHAIN-OF-CUSTODY RECORD <br /> SAMPLY :(Sign ur <br /> Date Shipped Carrier <br /> Phone -3 �' Airbill No. Cooler No. <br /> SHIP TO: b SEND RESULTS TO: <br /> Enseco-Cal Lab Client Name 1/—V-4z-� <br /> 2544 Industrial Blvd. Company G ALT KS <br /> West Sacramento, CA 95691 Address <br /> (916) 372-1393 �5,)-0 <br /> ATTENTION: (A k,-"- Phone <br /> PROJECT NAME I OS�`�F PROJECT NO. AcS IA P.O.NO. <br /> Relingyi ed by: ( igi n Received by: (Signature) Date Time <br /> Relinquished by:.-(Signature Received by: (Signature) Date Time <br /> Relinquished by: (Signature) Rece'v lab : (Signature) Date Tin e <br /> Relinquished from lab by: (Signature) Recel by: (Sign u r e Date Time <br /> ANALYSIS REQUEST <br /> Sample ID Sample Date/Time Sample Condition <br /> Number Description Sampled Analysis Requested Upon Receipt <br /> S1l�I Fk-� A .kA �aoSg-a VVI 6-7MPOS ii srLC� 7'rLC,pnSrs / 1 <br /> -AS <br /> Special Instructions/Comments: <br /> NOTE: UNUSED PORTIONS OF NON-AQUEOUS SAMPLES WILL BE RETURNED TO CLIENT <br /> Expected <br /> Analytical Immediate <br /> T.A.T's: Attention (200% surcharge) RUSH (50-100% surcharge) Standard <br /> Cal Lab ID Number: (for lab use only) <br /> Client Retains White Copy Only (Revised 1/87) <br />