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1-074f- <br /> —7 CHAIN OF CUSTODY RECORD -,C/ 0 <br /> [+d f1 }[TO� ' �p �v BCA Log Number _� <br /> Client name �C }� Project or PO# Analyses required <br /> f 5 3- <br /> Address 3Phane N <br /> �80 sK� KK riles vo. Zz:7g <br /> , <br /> Uly State Zip Report altenu n <br /> TLE�A`.xtf N 1 L 1, CA 4452 -jobb M11-LEV- FQA� <br /> Sampled by v yy arc <br /> Lab M ��1���OA Number <br /> Sample Date Time See key of <br /> number sampled sampled below Sample description containers Z�g� Remarks <br /> loog6,6, <br /> 1009&4 - MW <br /> 3 1004160,60- Mw- l <br /> 4 42 <br /> Mw- Z <br /> In 1b33 Joo466- MW- 3 <br /> 1,5 3) )0o9b(o-k(w-4 <br /> IZo'4 <br /> l D04bb-M W- 57 <br /> 4 I no 14046b-MW-(0 <br /> 10 Gq5-6- <br /> 11 055 IDo4� ,�ICi1�J-S <br /> Signat Print Name Company Dale Time <br /> Relinquished1by _ Ef <br /> e✓`,` �ai1��N� <br /> /V ,.L—/ �r-�i-ff�t! rt�ca,��� C�o.�C'o,P� 1 Z-1 Z- 1600 <br /> Received by <br /> Relinquishe <br /> Received by <br /> Relinquished by <br /> Received by Laboratory 91W r <br /> B C ANALYTICAL Note Samples are discarded 30 days after results are reported unless other arrangements are made *KEY A4—Aqueous NA--Nonaqueous SL—[Sludge <br /> 111085 Shary Circle Concord CA 94518(510)825 3894 Hazardous samples will be returned to trent or disposed of at client s expense GW--Groundwater SO—Soil PE--Petroleum <br /> ❑801 Western Avenue Glendale CA 91201(818)247 5737 Disposal arrangements WW—Wastewater <br />