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))L' ,3 <br /> U <br /> Science Applications Chain of Custody Record <br /> International Corporation COC No.: <br /> Date: /0� Pae of <br /> gCoe <br /> An Employee Owned Company <br /> Name Requested Parameters <br /> Address bv��u'WRIVLo- Laborato Name <br /> Phone Number —102.0 <br /> a � 't,. eal Address <br /> Project Manager <br /> Project Name CV <br /> __6 io Z..60. CA <br /> Job/P.O. No. AELOZ. — 24�—2-0 1 Q <br /> S m Si( gnat, ex- 11 1 Contact "I et�� <br /> ted Na 0 ix 10f -1w, <br /> katoratory No OBSERVATION <br /> Site ID Field Sample# Site Type Depth —Date Time Matrix CL� S,COMMENTS <br /> .............. SPECIAL INSTRUCTIONS <br /> ............. <br /> .............. <br /> ............. <br /> ............. <br /> -2 <br /> ............. <br /> ............ . <br /> ............. <br /> ............. <br /> ............. <br /> .............. <br /> .............. <br /> ............. <br /> L,D <br /> . ............ <br /> ............. 110:25 <br /> ............. <br /> '! 1�lzZl�. Ifs <br /> ............. <br /> ><.............. <br /> .............. <br /> .............. <br /> ............. <br /> ............. <br /> ....... .. . <br /> &03 <br /> ..... ...... <br /> ............. <br /> ............... <br /> ............ <br /> 10fZ 103 12 <br /> ............. <br /> /3 -35 2( 1 146 L <br /> ............. 1,912,z103 <br /> ............. 13, <br /> U OL J> <br /> ............. <br /> 100*, <br /> Relin Ots ed by <br /> Date RdddiVi3d'b Uaw. <br /> ex Total Number of Containers: <br /> Relin Ui ed .......... LL <br /> ............................................ <br /> .4 ............... <br /> ................ ........... <br /> Notes: <br /> .......... .................. ... Shipment Method: <br /> s <br /> 14.WOE 4 1012 <br /> S u e <br /> Airbill No.: <br /> �� !~ ........ . .......... <br /> ................................... Custody Seal 1 No.: <br /> .... .... ... <br /> .......... .... ........ <br /> .................... .......... .....�*................... <br /> ................................... ....... <br /> .................... ..... .............. <br /> I <br /> .... Custody Seal 2 No.:Time ........ <br /> Printed Name <br /> Field COC No.S: <br /> .flrinleid'NaRe. <br /> ............. <br /> ................................................. <br /> .......... SAIC Location <br /> ........... <br /> Co any ........... ....... Sacramento <br /> 3800 Watt Avenue <br /> .......... Wt <br /> Relinquished by Date R666ve <br /> ........ ... <br /> Sacramento,CA 95821 <br /> :. <br /> .......... . <br /> tel. 916-974-8800 <br /> ................. <br /> ......... .......: - <br /> Signature <br /> ..... ........ ............ fax 916-974-8830 <br /> ................ ........ <br /> ............ ............ ... ........... <br /> .................... <br /> ........... Project Manager: <br /> ............. <br /> 011 ... ...... <br /> ed Name' Time )t m <br /> 'Printqcl'Name*.,.,.-.-.-.-.-!-.-.-...7..:":.-............... 77 <br /> ........... ........ <br /> .......... <br /> ............... <br /> ............ <br /> : :. <br /> ...... ........ <br /> Company ..................................... <br /> ............. <br /> Science Applications International Corporation <br /> White:Laboratory P;nk:Project Manager Yellow Field Project Manager <br />