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� � � Illlllllif tttttttttt� Ittt� Ittttttttt� � I• � � � � � � � <br /> MccamptIl Analytical p a ytical Inc. CHAIN-OF-CUSTODY RECORD Page ' of ' <br /> 1 10 Second Avenue South,#D7 <br /> Pacheco,CA 94553-5560 <br /> (925)798-1620 WorkOrder 0204268 - <br /> Client <br /> Advanced GeoEnviron mental TEL (209)467-1006 <br /> 837 Shaw Road FAX (209)467-1118 <br /> Stockton, CA 95215 ProlectNo Lodi Theatre <br /> PO 16-Apr-02 <br /> Requested Tests T <br /> Sample ID ClientSamplD Matrix Collection Date Bottle 80218/8015 <br /> 0204268-OD1 INFLUENT ���41115/02 2 14 00 PM A�t}204268 002 EFFLUENT - — — — <br /> Comments <br /> Date/Time ^� , <br /> Relinquished by Received by <br /> Relinquished by- Received by- <br /> Relinquished <br /> yRelinquished by: Received by <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be returned to client or disposed of at client expense <br /> Bottle Type L-Liter V-Voa S-Sod Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />