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Pae of <br /> Chain-of Custody Record f 4 J �-F zzo <br /> ate. ��2 -7 3 � � <br /> ANALYSES REMARKS <br /> Project No.: S'3 (21/ Additional Comments <br /> Samplers(Signature: <br /> G y 4 <br /> m o n CO to m m a u� ) m °1 m <br /> fl N G T o a �N o o a V m a a a <br /> m a m m m a mo - c0 �] <br /> �rC a t 6 <br /> Date Time Sample Number a� a , a � a� M m � � jP tc <br /> w� w= w w w'� wv, u) o U z <br /> /(3 G 33-/ 0523 <br /> J 0 53-Z- d 5-2 3 I Y11 L I 111CW ,l <br /> r �� .s 3 � �= psz� �J - ✓ ✓ � � <br /> [C 1�5' 53� .S=f15 3Ix 41 <br /> (7 30 -5 - 05-2-3 k I r 6 <br /> �O sy- Z - 0s7--3 <br /> t� / ! �S Sal-3-0 2-3 ✓ f l� <br /> 75-0 Sy- q -07-23 <br /> i 710 -ST/10�� <br /> Laboratory: Turnaround Time: Results W . n <br /> .•r// V a / Ma.+'4+'44 1Vwe3 Total No. of Containers <br /> r G.' 1,bW� - _ Qrc��ti G�„�' <br /> Ralinqu ed by (Si ature): Date: Relinquished by (Signature): Data: Relinquished by (Signature): Date: Method of Shipment: <br /> Printed N me: Printed Name: Printed Name: Time: Laboratory Comments and Log No.: <br /> Re -e,1,C"17 Time: Time: <br /> Company: IM q�'� company. *mp <br /> I <br /> Received by: Date: Received by: DatD to <br /> Printed Name: Printed Name: Timq i 1,}�� Time: �eQrnetrix CTime: l� NU <br /> Company: Company: r', 2101 webster Street. 12Th Floor•Oakland. GA 94612 <br /> Company: Phone: 510-683.4100 Fax:510-563.4141 <br />