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CHAIN OF CUSTODY RECORD I <br /> [Address <br /> lient name --,�- <br /> BC l uy rh,nuu, <br /> Project or POI �'--- --- -----.-_-- <br /> Analyses required <br /> Phone I <br /> City,State•Zip — ' <br /> a <br /> _ Report ti mien � � o <br /> �l , <br /> Lab r )2KTimSampled by <br /> Sample Dale eym a' <br /> ntatnber See key Number <br /> trampled rtarnpbd below � of `ao0r°F <br /> • 8amptedesa illon ' ?. contak»rs <br /> '7 + Remarks <br /> 1 <br /> .�IgnatUle :-7 <br /> Print Name <br /> Relinquished by Comte°y Dat <br /> Time <br /> EFRIONI"d by <br /> I Rellnquls ~ y rr x /� <br /> I Retashred by <br /> R*WWI s"by <br /> R*Wkvd by"boratory -- <br /> BR�7 NAND CALDWEL�Smw <br /> ORIESNote: <br /> R )426-2500 Samples are discarded 30 days atter results are reported unless other arrangements are made <br /> Q3 SI)rrlhPfth�17f= 91105 (M)795-755 Hazardous eamplea will be relusned to client or disposed of at client expense <br /> f`f i1 <br /> --... ,.T.. ter- ����--—���-�-�..�.... . � -.. ,.--.�..,.....,_.-. .•�.-._----��—�—�...,� -. —�--�-�-� <br />