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M M M i M M MM M MM <br /> Vironex A Chain of Cu y Record <br /> 3002 Dow Ave, Ste 406 <br /> Tustin, CA 92780 <br /> 1-800-847-6639 <br /> Client #14tw6 - 6-4..0 DateJam-ZZ- Page Of <br /> Address�2 o AaX e_—,.._WeYo Project Name 5-�ocat�Q,•L- eco - twc.� s� - <br /> Phone46!�-O) Yz-r- 01-W Fax�6sa� -2- 05'Sr`1 Collector Client Project# <br /> Project Manager JaL",-, Batch # 7� Proposal#�S{ <br /> ro N <br /> m <br /> N <br /> oCU <br /> U <br /> H <br /> 0 0 0 <br /> ti 11i 7 Q mo <br /> 00 0 0 u�-, Lo o o <br /> N CD t- 00 Y — �- �- O O <br /> Ui @ W <br /> Sample Container co a Q ¢ Q Q ¢ Q ¢ �- 0 m CU <br /> Sample ID Date Sampled Time Type Type w w w w W W w w W _J Q. Comments F° <br /> t �ZZ•Oo t e a V1_r4_ AL-ET i f <br /> -- 2d S zZ-ov o<i'5Sv , L. F X x <br /> S- Z2-00 .L 1 X <br /> - 1/0` S- z Z.-00 OZ/6 <br /> -z V X <br /> f - U <br /> Z7--an a ,I <br /> 3- _Zz-c+a Ivx� 5� �4cE <br /> - /a- <br /> LJ S- 1 z- 1 oo r4-,r.r, / <br /> - Cry--3 5-a.z-orz. 11 co ti cJ U.%sX <br /> — 10 1 22-un 1/ 2,4U l <br /> z-z--W <br /> 3o' <br /> Relinqui e y (signature) Date/Time Received by (signature) ate 1 Time Total#of containers � Notes <br /> l.-..r r 24-a O Ctm - g Chain of Custody seals YIN/V 56,1 5m-0.0 <br /> 0.0 <br /> Relinquis by (signature) DPW I Time Nceiv6d by (si nature) Date I Time Seals intact?YIN/& 6,VV Sit,-Pk S <br /> Received good condition)io <br /> � �n44 s <br /> Relin ished by (signature) Date I Time ceived by (signature) Date'/Time <br /> Turn around time 7 <br /> Sample disposal instructions Disposal @$2 00 each _ Return to client Pickup <br />