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k <br /> ViV <br /> fi <br /> Chain of custody Record ^ <br /> Company Name Project Manager.-Contact / e <br /> AftPagp et <br /> Speaal OA/0C Protocol PARAMETERS FOR ANALYSIS � <br /> �•-� <br /> ailson (Cirde) ,r at' <br /> Project No, Project Name d Laboratories EPA CLP EPA SW 846 o"a} d <br /> �.. rL ' <br /> E.S acus l,a Road East NY5 DEC N <br /> r rfr-� ��T E.Syracuse,New York 15057 N.1 TIER i ALIFORNI :• 1 <br /> 315 432'Jli0$ar 800-9S0.05C)6 <br /> TYPE T1ER fl OTHER(spearys, <br /> SAMPLE LOCATION/SAMPLE ID Date Time E a m i ='l`. ' <br /> s m Y Laboratory <br /> a u°� p A B C D E F ID J <br /> G H I J K Number � t <br /> /TOG tnalne,•rtnC� <br /> 1 not- •��•j4-'�IU.I <br /> 'll✓ / r� Ennlnc•Fring rive . <br /> 74- <br /> Enrair,ecranq crai+cr <br /> "A--'4-1 a41 <br /> Lngineering Srient e 1 {., <br /> gip_=4-1951 Watar k 4734-004 : <br /> I. IF' NLANK <br /> _ f <br /> REMARKS: ! '' X, <br /> � :ten, <br /> SALIPLERS <br /> NAME: `> SIGNATURE: ' <br /> SAMPLES RELINQUISHED 8 � <br /> NAME: ,r ui „� r LES RECEIVED BY: <br /> SIGNATURE; DAIS:`Jl� ;i NAME: Received For Laboratory Y' r <br /> TIME:/ S. SIGNATURE: DATE: (Sijnattrre) DATE::X`I,�f 5 <br /> NAME: TIME: ►•. TIME:"ctc�s' <br /> SIGNATURE: DATE NAME: CUslody Seal[ntaq?Sam le <br /> TIME: SIGNATURE. DATE: P L3 yes Q/yyy ®M•A. <br /> NAME_ TIME: Shipment Complete? Q Yes ❑Ay r� <br /> SIGNATURE: DATE: NAME: LabStor, <br /> TIME: SIGNATURE: DATE. Location A B C D E F <br /> TIME: (Rel.a) <br />