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CHAIN OF CUSTODY RECORD BCA Log Number <br /> Client name Project or POM Analyses required <br /> q 2-� <br /> Address Phone# IQ <br /> City,State,Z Report fin <br /> n <br /> y �rx DILL CA- �!� <br /> Tye. Sampled by�'JJ ,xG —1"-•N�l�L � w <br /> Lab F4 I"1 I L�Nle --� ' Number <br /> Sample Date Time See key of v <br /> number sampled sampled below Sample description containers •2`g Remarks <br /> I I . IIZ� W G�II Z <br /> 'li Z <br /> 3 <br /> Is��t RC- 14 2 Z <br /> 1044 Z Z <br /> 10?V 13C- I L <br /> PSC-l3 Z 7i <br /> store V , ` -I Print <br /> Name/ / /1 Company Date•� Time <br /> Relinquished by 5.��/N 1'�r I-Le IC.V G(vA,& ¢lam- - ,�//• L ` . I I..ft /)mac <br /> Received by <br /> Relinquished C7�n �C H /ya`s <br /> Received by <br /> Rellnquished by <br /> Received by Labor ry <br /> B C ANALYTICAL Note:Samples are discarded 30 days after results are reported unless other arrangements are made. 'KEY: AO—Aqueous NA—Nonaqueous SL—Sludge <br /> Harerdous samples will be returned to client or disposed of at client's expense. GW—Groundwater SO—Soil OT—Other PE—Petrolemn <br /> ❑ 1255 Powell Street,Emeryville,CA 94808 (415)428-2300 <br /> [] 801 Western Avenue,Glendale,CA 91201 (818)247-5737 Disposal arrangements: <br /> ❑ 1200 Pacilico Avenue,Anaheim,CA 92805 (714)978-0113 <br />