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KIS CHAIN OF CUSTODY RECORD <br /> SEND RESULTS TO ALL PARTIES LISTED BELOW.• <br /> KLE46## <br /> Florin 0Wei!( Fionn@kleenblast. com <br /> Industrial Services <br /> 50 Oak Court, Suite 210 <br /> Danville, CA 94526 ND � na>� <br /> Phone 925-831 -9800 - Fax 925431 -9183 ► 11►� Solu�gi5 <br /> L bor �0 - t o - 155' CLIENT*; 1 . yalv* nq 5010 0yys <br /> IOBSITE1 o,./ J� 1 aq 4 �S /irr <br /> COLLECTEDvBY p <br /> SPECIAL <br /> INSTRUCTIONS: <br /> Di!QCAM 17- TTLC , STLC 10X RULE, TCLP as needed SELECT:T 0 72hrs Standard Rate <br /> 1 11j 8 Metal TCLP TURNAROUND 48hrs SR + 25% Premium <br /> ANALI�SIS _ _ _ ( ) <br /> REQUESTED, ( j 17 Metal STLC T/ME DESIRED SY ( ) 24hrs SR + 30% Premium <br /> ( j Other, Note In Special Instructions Section MARKING OR O Same Day SR+ 60% <br /> HIGHLIGHTINGt <br /> Sample ID Lab 1D Collection Matrix Notes or Sample Map, Etc, <br /> Date <br /> Q f lav ' Solid <br /> Solid <br /> Solid ; . <br /> •rte � .� - k <br /> By my signature below i attest that this sample was collected In accordance with KIS' sample directive 301101143 y other raguiatory compliant means. <br /> elinquis pate `?. t $ �Q/ Received By Date / 1 <br /> • & Time & Time <br /> elinquished By: Date Received By Date <br /> & Time & Time <br /> Relinquished By: Date Received By Date <br /> & Time & Time <br /> Send Sample To: Enviro-Chem , Inc. Laboratories <br /> 1214 E. Lexington Avenue <br /> Pomona , CA 91766 <br /> PK 909-590-5905 <br /> Fax : 909-590,5907 <br /> CA-DHS EL.AP Certificate #1555 <br /> OKIS DOCSRceychol000alC0Cj0M78&0 ! C0C,•Slandard.d0c <br />