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Bill To: , <br /> CHAIN OF CUSTODY RECORD <br /> Sherwood 8071 N. Lander Avenue <br /> P.O. Box 937 <br /> L��� Hilmar, California 95324 <br /> (209) 667-5258 Attention: Phone: <br /> C O R P O R A T I O N FAX (209) 667-2581 Page of <br /> Job Number P.O.# Project Name <br /> Sample <br /> rSignature) Site Address vGj 0, <br /> 01 <br /> NUMBER TYPE <br /> SAMPLA I <br /> E OCON ZAT TIME SAMPLE <br /> (IDENTIFICATION (MTH/DAY/YR) (HOUR/MIN) OF (GRAB OR MATRIX <br /> CONTAINERS COMPOSITE) QJ' REMARKS <br /> _P <br /> 44 <br /> Relin uish y:( lgnature) Date/Time Received By-(Signature) Date/Time <br /> • $ /G � 3.3 S � TURNAROUNDTIME <br /> elfinquished ignature� — D; a Received By:(Signatur ) Date/Time 'S 24 HOUR El Z-1 ., ����� 48 HOUR ❑ <br /> Relinquished By:(Signature) Datemme Received By:(Signature) Datelrime <br /> 5 DAY ❑ <br /> + DIST.;dUBUTION: Original-Accompanies Shipment Canary Copy:Sherwood Pink Copy:Sampler NOTE:Samples are discarded 30 days after results are reported unless other arrangements are made. <br />