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KIS CHAIN OF CUSTODY RECORD <br /> SEND RESULTS TO ALL PARTIES LISTED BELOW <br /> Florin O 'Neill Flonn@kleenblast. com <br /> Industrial Services <br /> 50 Oak Court, Suite 210 IN OMA 4{ R i� <br /> , 11 ,+ Y�x • r� SL' '` y� l <br /> Danville, CA 94526 1 t� i � <br /> Phone 925431 -9800 — Fax 925.8314183 kJA lith SOWcd$ <br /> Project4 CLIENT. <br /> NOV)be,; Seo - i 'W '55' co ?41 Viob h Sol u-i 0 ns <br /> JOBSITES /0'fS%irk <br /> CULGEC7'ED 8l! � � <br /> SPECIAL <br /> INSTRUCTIONS: <br /> CAM 17- TTLC , STLC 10X RULE, TCLP as needed SELECTTtE 72hrs Standard Rate <br /> ( <br /> ANALYSIS ) 'I Metal TCLP TURNAROUND . ( ) 48hrs SR + 25% Premium) 17 Metal STLC TIME DESIRED BY 24hrs SR + 30% Premium <br /> REQUESTED _ , ( ? <br /> ( ) Other, Note In Special Instructions Section MARKINGOld O Same Day SR+ 50% <br /> HIGHLIGHTING *' <br /> Sample ID Lab 1D Collection Matrix Notes or Sample Map, Etc. <br /> Date <br /> Solid <br /> Solid <br /> jr <br /> Solid {[} <br /> By my signature below I attest that this sample was collected In accordance with NIS' sample directly# SOW! B op y other regulatory compliant means. <br /> t3etli quis ,� DaTe `a ' � Received By. Date t <br /> S Time <br /> e°inquished By: Date Received By Date <br /> & Time & Time <br /> Relinquished By Date Received By Date <br /> 8 Time 8 Time <br /> Send Sample To : EnviromChem , Inc . Laboratories <br /> 1214 E . Lexington Avenue <br /> Pomona , CA 91766 <br /> Ph : 909-590-5905 <br /> Fax. 909-590-5907 <br /> CA-DNS ELAP Certificate #1555 <br /> C3KIS DGCS%Rccycbog Dws1Ccoogm2mI _CoCµStsixtvddoc <br />