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-ETS EABIH TREATIMENISYSTEMS- <br /> �r <br /> ENVIRONMENTAL CONSULTANTS � ��, ? � <br /> CHAIN OF CUSTODY RECORD Jac. arc <br /> PROJECT NAME: <br /> SAHPL Number of gy�a Q �� <br /> E (signature) : y'4 <br /> Containers/ '�� qOt <br /> Type of 4 <br /> Date Time Sample Location Sample el <br /> J/ q Lab 1.D. <br /> .:., —71 j <br /> Jr <br /> i <br /> Re qu ' ' hed by; Date / Time ceive� by:\ Relinquished by: Date / Time Received by: <br /> v to%5 � : <br /> ^ <br /> an ' Com an �\ Company: _ Company; _ __ _ <br /> � Tie?inquished by: Date / Time Received by: Relinquished by: Date / Time Received by: <br /> I <br /> I I7„mpan : Com an : Company : Company . <br /> ' -i nquished by: Date Time Received by : Relinquished by: Date Time Received by : <br /> i <br /> i <br /> Cam an Com an Company: <br /> NOTE: In preparing legal documents always use ink and signatures <br /> (209) 384-1041 MERCED, CA 95340 <br />