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AU'1 SAN JOAQUIN COUNTY 'r r lq�425 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> H s 600 East Main Street, Stockton,CA 95202 ` 2� O 7r <br /> Telephone:(209)468-3420 Fax:(209)464-0133 Web:www.sjgov.org/ehd <br /> C PO W ��� ,//rl•6• � <br /> �o�� roilct7r CHAIN OF CUSTODY RECORD <br /> I. Sampler's Name -l-fr(�(I �Q Title S ✓ )2 C—H-S Unit <br /> 2. <br /> Date Time Item <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> tgnttabnlry30 <br /> t M Reactivl <br /> TTLC C1 TCLP <br /> ❑STLC,If necessary <br /> 096-Hr Fish Bloassay <br /> ❑Cam 17 Metals❑pH <br /> ❑Ignitability,❑ <br /> Reactivity <br /> ❑TTLC Cl TCLP <br /> ❑ � t"�'ru n <br /> STLC,if necessary 60�75U <br /> 09&Hr Fish Bloassay -{�/'� <br /> (:]cam 17 Metals❑pH o run <br /> ❑It ehabillty, ` <br /> Rtactivl <br /> ❑TTLC ❑TCLP <br /> ❑ST'LC,If necessary <br /> [196-fir Fish Bioassay <br /> ❑Cam 17 Metals❑pHTQ1,t ld I <br /> ❑Igoiubillty V^ <br /> Reactivl <br /> -F- <br /> 0 LC <br /> ❑TCLP <br /> ❑STLC,If necessary <br /> Bloassay <br /> 096-Hr Fish Bioassay <br /> ❑Cam i7 Metals❑Pli ��Pk--s+G'^�1 CLP <br /> ❑i gnitabili ty <br /> OReacti-Aty <br /> 3. X Evidence tape p4:C_- Sample transported in iced cooler <br /> 5. Relinquished by <br /> Name Title Date Time <br /> Received by / �CV'1y f�� ) i iG-F✓t0 , CA emLS a)4 <br /> Name i Title Date Time <br /> Remarks (condition/temperature) <br /> 6. Relinquished by c6,4,g5�- �Q 2L l LON <br /> Name Title y Date�,C� Time <br /> Received by ( C �I-G �l / 0 /l <br /> Name L' ` OL Title Date Time <br /> Remarks(condition/temperature) <br /> 09-07-2007 <br />