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DeMenno/Kerdoon <br /> Chain of Custody <br /> "Recycling For A Cleaner Environment" <br /> 2000 North Alameda Street-Compton,CA 90222 <br /> (310)537-7100 Fax:(310)639-2946 <br /> CA-DHS ELAP Certificate#2037 <br /> Client: It I <br /> Contact, Tel. Fax: <br /> Address: City: State: Ca Zip Code: <br /> Project Name: S mpler(s) SigD4ture, <br /> 6 a <br /> Project Manager: GATELY Approved By: <br /> Due Date E) Regular ❑ Rush Days Comments: <br /> • Lab Date Time No. of <br /> SWple Description ID Collected Matrix Containers Analysis Requested <br /> ,o <br /> 0 1z 071(U 17&K <br /> C rfV4 <br /> rAr7F,- <br /> rAJ COLM" /7 ,4,/, <br /> Sample Conditions: Seal d Intact Broken 011None; Temperature ❑ Cold m,* Other <br /> Relinquished by (Sigftauw*#-- Received by (Signatur Date/Time <br /> W. <br /> Relinquished by (Signature) Received by (Signature) Date/Ti me <br /> ceived by (Signatur QateJime <br /> Relinquished by (SignaturejO� <br /> SPECIAL INSTRUCTIS'/-- <br /> Results to sgatelygasburyewcom lyancy@asburyenv.dbm wmorse@asburyenv.,com <br /> WHITE COPY—Client PINK COPY— Courier Pae of <br /> 4C , <br />