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GI 's Ll L�"' - L" <br /> Chain of ustody Record <br /> 4, <br /> Science Applications COC No.: <br /> International Corporation Date: <br /> age of <br /> An Employee Owned Company Re nested Parameters C6 <br /> Name ,k <br /> Name.. Lobj lik <br /> Name <br /> 7 n IVA 10 S')AU�--oleCA %437� Laborato Name <br /> Phone Number q(6 6. p:Z, o <1 L,,4)3 <br /> Project Manager 7-6 L0 Oe-L- N Address <br /> Project Name r,ict C,X 13 Iq <br /> Job/P.O. No. Y2 z'6—20 <br /> IPA <br /> Sampler Signature) Contact <br /> 'I (Printed Nam <br /> O.-Ot Ir­ CJ <br /> &41 <br /> Laboratory No. .41 bi AU4 <br /> Site ID "-�i&Sample# Site Type Depth Date Time Matrix • OBSERVATIONS,COMMENTS <br /> ............. <br /> -7T— SPECIAL INSTRUCTIONS <br /> 3 <br /> .............. <br /> ............. <br /> ............. <br /> .............. -(3-/0 '30 <br /> 7.............. <br /> ........... <br /> .......... <br /> —A <br /> -SB-13- <br /> 10-,'fL <br /> .......... jo <br /> -3/1" <br /> R"/0 <br /> X <br /> . ......... <br /> ............. <br /> ........... <br /> ................ <br /> .... ...... <br /> ............ <br /> VOLD <br /> .......... <br /> ............. <br /> ............. <br /> ............. <br /> ............. <br /> LS <br /> ,Ai, ,�at t <br /> L LWA <br /> V X.. <br /> Relipq i ed by Date ... Total <br /> ir <br /> ma&Al Dbt&* Number of Containers: <br /> ..................................... <br /> Notes: <br /> ............... <br /> .............. Shipment Method: <br /> ..................... ....... . <br /> /O/Z 0 <br /> .. ........ <br /> ...... ... ....... <br /> Si a-t—ure 9 Airbill No.: <br /> ......... <br /> ...... ........ <br /> ....................................... <br /> Custody Seal 1 No.: <br /> . ......... . ................ <br /> 'iaMA . .......... <br /> ....... ...... CS Custody Seal 2 No.: <br /> Time <br /> Printed Name -77.7.7.. A, <br /> -Pdn16q'Na.............. Field COC No.s: <br /> ........................... <br /> ................ <br /> ............................. <br /> ............ ........... <br /> ....... ....... ......... <br /> SAIC Location <br /> .......... ...... <br /> .-------- ---'-*-'-*_'_'-"_-*-'-*-*-"-'_'_'-.-:.:- k pl <br /> .art <br /> v........... ­6........... ..... <br /> Company .. ....... .............1.r ......... LD <br /> ...... ........ ......... ............. Sacramento <br /> .......... <br /> -.-.-.-....'-'-' *-'-'-*-*-,-*-,-*." �, Pl.�), 3800 Watt Avenue <br /> Relinquished by Date Re'c'ei i v .. ...... ..0 rT+e. <br /> ................. <br /> Sacramento,CA 95821 <br /> .... . ....... Xrel.t916-974-8800 <br /> . ......... <br /> 10/2-7703 . <br /> . <br /> SignatureSig.ature...... ....... . ...... ............. <br /> . ....... <br /> fax 916-974-8830 <br /> Project Manager: <br /> ................ <br /> ....... ...... <br /> ...... ....... . ....... <br /> Time <br /> Printed Name ........ <br /> .. ..... <br /> ... ................. .......................... <br /> .... ................. <br /> .................... <br /> Company <br /> ............. ............ <br /> ............ <br /> Science Applications International Corporation ..;"';...... <br /> White:Laboratory Pink:Project Manager Yellow.Field Project Manager <br />