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OX=003 a, 0(pr o/& 3 <br /> Fein-Of Custody Record 01 Rake; <br /> J'roject rho„ 'l -f, 1 f ANALYSES REMARK <br /> ;iAmp,lers(Si�na[ure:J <br /> i5 Addi[ional Comm-ants <br /> pQ p <br /> Date Tlme Sample Number ui_ 4 .7 fall <br /> qq. <br /> W W w L w 90 <br /> At XP <br /> r10 f t <br /> JN I <br /> Laboratory; Turnaround lima, Ie6ul Io; <br /> No, of conialaors � <br /> nRcAIshod ( l�na[ure}: Rate: R�rlingeal5hed h Si �r Rura a a' <br /> Y 9 = Helinquishod by {$Ignawre}- 061e: Metlioo of Shipmen[' <br /> Pr-Ited Name Printed dame- Printed dame: <br /> Time- Time Time= C aoraiory nmrnnt5 and Log C�Eo-. <br /> Cornpan � Com an <br /> R Y= Campany: <br /> Receivpd by: Date: Lneaewed by. �BC�' Ae ed by' date: <br /> Prir�led iVarne- d deme Prinle#1 ame; <br /> Time: Jme; l Ti ma: <br /> �iumpany' L- +ny. Company= �/ 2101 W&barw 91raa5- 121h Floor• Oakland, CA *41612fLJ7 Phonr;670-$63.4100 Fq%: 516-4r"-�14: <br />