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� I2 Page ---L—of <br /> Environmental Laboratory <br /> 8880 Interchange Drive Analysis Request and Chain of Custody Record <br /> Houston, Texas 77054 <br /> 713/660-0901 <br /> Project No Client/Project Name Project Location <br /> I oDcj�b CZ sa-L-- ! <br /> Field Date a Sample Sample LABORATORY <br /> Sample No/ and c Container Type(Liquid Fraser- ANALYSIS REQUESTED REMARKS <br /> Identification Time (7 Q (Size/Mat 1) Sludge Etc) votive <br /> ��� y ++ <br /> K0 <br /> IL(ql I <br /> vJ'Z_ I i r'a +L <br /> Iti I <br /> 1 ` 3 t� <br /> LL tl <br /> it +4 iL it <br /> lam' I1 kk <br /> lyl� <br /> Samplers (Signature) Relinquished by Date �'t Received by Date Intact <br /> 'ire <br /> 7-f <br /> Time (Signature) <br /> (S+gnat ) IG---,L[, <br /> Time J j 3� Time <br /> Relinquished by Date Received by Date Intact <br /> (signature) (Signature) <br /> Affiliation I Time Time <br /> Relinquished by Date Received by Date to <br /> (Signature) (Signature) <br /> Time Time <br /> SAMPLER REMARKS o I rato Date - laboratory No <br /> (Sig j Time <br /> Dala Results to <br /> Seal 4 <br />