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Aprit <br /> r-'" r-'t r- 1 r--= c--* c-* r--' r--r r"- r"?, r-'r. f-7 r-Tr--* f--T <br /> m(ODKE ® CHAIN-OF-CUSTODY RECORD <br /> LABORATORIES INC. S <br /> Dille page t� of <br /> •analysis Requested <br /> Site Address: <br /> v` <br /> -- c Comments <br /> c <br /> Project: <br /> 0 <br /> Sampler (signature): Q o <br /> Sample No. Date Time Location <br /> - <br /> PU-30 Is45 <br /> Intact: e, <br /> Notal No.oFeontainers <br /> Cold: Yes N/A Received on site <br /> RELINQUISHED BY EC ' VfD BY RELINQUISHED BY RECEIVED BY RELINQUISHED BY RECEIVED BY <br /> Signal e Signature 5ignaturc SI'LlniltUl'L' <br /> Signature <br /> Printed N me Pril ted NPrinted Name printed Name Printed Name Printed Name <br /> l G,a t at L/�j <br /> Company Company Company Company Company Company <br /> ate s timci Date [imct� me Date TiUatc Time Date Time Date Time <br /> 14B SO. VINEWOOD! STREET • ESCONDIDO, CA 92029 PHONE (619) 735-3208 • FAX (619) 735-2469 <br />