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0 0 0 <br /> Yl CHAIN OF CUSTODY Page of <br /> Delta Environmental LABOR TORYSAMPLE55ENTT0 <br /> In/a <br /> Delta Consultants,Inc (` <br /> Environmental 3330 Data Drive,Suite 100 IGS A <br /> Consultants,Inc Ra C 1&1638 2085 • FAX 9161638 8385 <br /> PRD) NO PROJECT NAME C�,GY(q guested& ADDRESS <br /> u h a Q PROJECT LOCATION Container Description <br /> DV PROJECT MANAGER p C 1 ` <br /> 4 � <br /> SAMPLERS(S e ) h vv Yb d o 1 Z <br /> 0 � -�, � 639--7101 <br /> ° 11� <br /> LABORA. m REMARKS <br /> TORY SAMPLE ID DATE TIME SAMPLE SAMPLE LOCATION j <br /> SAMPLE ID TYPE z <br /> IL <br /> Relinquished b ffignaturej Date Time Received k(Signature) iRelinquished by lgnsfure) Da Tlms Racelved by (Signature) <br /> Relinquished by (Signature) Dat• Time e v y Snetate Time Tumaround Time ` <br /> � v/JI iL <br /> �'-� <br /> Sealed for shipment by (signature) Dale/Time Shipment method <br /> Sampler Comments ' Q Laboratory Commode. <br /> Condition of samples; <br /> White Return with analytical results to Delta Yellow Laboratory Copy Pink Delta's Copy <br />