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(f,0N•rr1'AcT" No. d-036-150-0 <br /> Anlab Client Code: CHAIN OF CUSTODY RECORD Page of <br /> CLIENT INFORMATION <br /> Company:GV (/(f Contact Name: OE Anlab Use Only: <br /> Rtab ,b <br /> Address: 044,:3 gnongiQr Hours: <br /> ANALYTICAL LABORATORY City: L State: ( Zip:95?Z Miles: <br /> Billing Address: SA • 914J-7-0 , E,< ,rj1-M Equip.: <br /> 1910 "S" STREET • SACRAMENTO, CA 95814 Telephone: 30-4 FAX: (.-M• Holim <br /> (916) 447-2946 a FAX (916) 447-8321 <br /> . Number: IGI-01 Project Name: CAL- % AILV <br /> i <br /> Sampler's Name: Sampler's Co.: 16 S �..oNS7J f1A� <br /> Sample Type Number of Containers Preservation <br /> ANALYSIS > w w ss P G V s T A e <br /> W 0 L L L 0 T E C A <br /> I U A A A E M I 5 <br /> L 0 S S R P 0 E <br /> G T S <br /> SAMPLE IDENTIFICATION Data Time O F IL <br /> C E <br /> U✓ W <br /> I111-04-Mllkff- n <br /> COMMENTS/SPECIAL INSTRUCTIONS: / C C Q TYL "„ SAMPLE DISPOSAL: C HOLD <br /> fig- �G TURNAROUND TIME: , <br /> �- /\ f�� VtOr..... !IG T7O �S 70 Li./.�E '9 n RETURN ❑ DISPOSE <br /> 24 HOUR C 4B HOUR C X72 HOUR <br /> SHIPPED VIA:ArQsS" 004v -e�= n6le—d&,EVS Z- G <br /> 5 DAV r - STANDARD i <br /> OF 01-30,LER �r M La' ER A ELl_ OA/ 10131/74- -30- UPS El FED-EX ❑ eus <br /> SAMPLE RELINQUISHED BY PRI/NT NAME/COMPANY/ / DDATErrIME 1 REC IV D V PRINT NAME/COMPANY <br /> �� i As.J�'p'r�,A. r�.�t(!f �• �// �/�! ��� A�S �-L.A'L <br /> ANLAB WILL EflFORM THE SERVICES IN ACCORDANCE WITH THE NORMAL STANDARD OF WORKMANSHIP.IN THE PROFESSION.THE TOTAL LIABILITY OF ANI-AB,ITS OFFICERS,AGENTS,EMPLOYEES OR SUCCESSORS,TO THE GUENL SHALL NOT EXCEED THE INVOICED AMOUNT FOR SAID <br /> SERVICES, IENTS'ACCEPTANCE OF A WORK ORDER ANDIOR PROPOSAL RELEASES ARIAS FROM ANY LIABILITY IN EXCESS OF THE INVOICED AMOUNT FOR THE SERVICES,NOTWITHSTANDING ANY PROVISION TO THE CONTRARY IN ANY CLIENT PURCHASE ORDER OR CONTRACT. <br /> i; All hazardous waste samples will be returned to client or billed for disposal. <br />