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CHAIN OF CUSTODY RECORD BC log Number <br /> Client nameem _ Project or PON Analyses required :, + <br /> Address Phone N <br /> a <br /> ql - yY4-o/,.,z3 �° �J 0 <br /> City,State,zip Report attention �t G 4. o `00 <br /> vu c�a S feH �Ya <br /> Lab �_ Sampled by HO'P <br /> Sample Date Time See key of <br /> number sampled sampled below Sample description containers i,�l �`l �a�� Remarks <br /> . V <br /> a Z /030 <br /> 3 zr 46 60 ATR <br /> 60 <br /> _ <br /> Signature Print Name p Company Date Time , <br /> Relinquished by �r5a A S ✓1 Iq �� � .d A C/2 /,7 <br /> Recelved by <br /> Relinquished by <br /> Recelved byVk <br /> r' <br /> Relinquished by x F411 <br /> Recehed by Laboratory A, 71 <br /> WROWN AND CALDWELL LABORATORIES Note: <br /> ❑i255 Ptnwell Stroet,EmeSamples are discarded 30 days after results are reported uhjess oth6Qrranger,,onl3 are made. <br /> Ila,CA 84808 (4i5 428.2300 r <br /> - Hazardous samples will be returned to client or disposed of at <br /> clientense ' <br /> D.3;`3 South Fair Oaks Avenue,Pasadena,CA 91105 (818).795.7553 - <br /> ❑ 1200 Pacifico Avenue,Anaheim,CA 92805 'KEY; AO—Aqueous NA--Nonaqueous SL—Sludge bW—Groundwater••SC-Soil OT•.-Olher PE—Petroleum <br />