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AIR TOXICS LTD. 180 BLUE RAVINE ROAD, SUITE B <br /> AN ENVIRONMENTAL ANALYTICAL LABORATORY FOLSOM, CA 95630-4719(916) 985-1000 FAX (916) 985-1020 <br /> CHAIN-OF-CUSTODY RECORD <br /> Page _. atContact PersonM-iJ r GZ?r°r o,� <br /> Project info Turn Around Time <br /> Company -± �C <br /> �; #6dd PO # )C G ❑ Normal <br /> Address CAAt ���• l{vP Cly a StateC- Zips Project # �' O [g"Rush t <br /> Phone (C (o ) - ora 3 FAX - �� Project Name �� CJ 12�s Specify <br /> Collected By Signature <br /> Lob Field Sample I D Date &Time Canister Pressure/Vacuum <br /> I D. Analyses Requested <br /> Initial Final Receipt <br /> S-r - rEva C� ion a� QS Ta IY <br /> f <br /> z <br /> Relleed By.(s d Cu pm!Name Notes <br /> Reltru;uishad By(5 to ) telT6ne Received By(5igna re) Da e <br /> Relinquished Br(signature) DetalTime pecefved a <br /> stall rile Tem (°C G nddi Guslod Seals Intact? Work Order# <br /> on� N/A <br /> 1 <br /> Form 1293,;v OG <br />