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MPDS <br /> Services, Inc <br /> CHAIN 01' CUSTODY <br /> ANALYSES REOUESIED TURN AROUND [INE <br /> SIZE HARE d ADDRESS e V Ea <br /> 1PLER r <br /> � o ( �0C (U ` ifnc <br /> 1NESSING AGENCY / C cz C 4 v c� y \ <br /> } � u 'j <br /> NO 44(1 ItEHARK5 <br /> SAMPLE Of SAMPLING <br /> y t <br /> 1D NO DATE TIRE SOIL APER 8A6 CORP CONT LOCATION <br /> ,1' " <br /> JA <br /> ltriqulslled (signature) Dale/Time cc ved �igr+nturc)12—�f--3 lite fo(louing RUST BE completed by the laboratory accepting samples <br /> lZ for analysis <br /> �i« 1'7 1 5 `S 1 Have all Samples received for analysis been stored in ice? <br /> L lshe by� (Signature) D to/Tilrrc Rece)vet! by. (j t911aturc) 2 U111 sanpies remain refrigerated until annly>:cd7 <br /> ilnqulslled by, s 4gnature) D to/time �Rnec.e.ivaed by (Signoturc) <br /> 3 Did arly sanTl(es received for analysis hove head space? <br /> Y tL,4 q=j— U`'1 Uere samples in Bppropriate containers and properly packaged? <br /> e rKluIsit ed by (Sfgnarure) Date/Time Received by (Signoturc) �4 <br /> Signature Titte Date <br /> 2101%t111WL11 IN1Y1. ti11i1L IIXI <br /> f Imunl G1111urni,19152(1 <br /> . � � Til SIU(02 511X1 1 1) t1(/12 <br />