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[ [ t t t t t I I ' ( - I t t t t C [ t t <br /> CHAIN-OF-CUSTODY RECORD <br /> Send Report and Invoice To: _ <br /> Terrasearch, Inc. (Environmental) Sheet_it of C-O-C Control No.: 61� 76 J b 17 61 <br /> 1580 N.Fourth Street Project Name: W, C j �' V,t/ c <br /> San Jose,California 95112-4676 Project No.: S,?/c, , 01 <br /> ti <br /> (408)453-1180 Samplers: <br /> ) Carrier/Airbill No.: <br /> LABORATORY NAME: � �U V- f j-l1 V I I ft��le',i;�?./ � Telephone: �%19'Y,(_, l6�6 FAX: <br /> Address: 7( Ll /f v (1 I c-.f �T,l R1 h ' ru S C% Certificate No.: 170,E Contact: i{4' !� C• `tf <br /> SIGNATURES (Nam p, C mpan,_Dat and Tim ): U f <br /> y�' f� ,/ <br /> Relinquished By: ._.G —,� lam,ti. , . %%° ,� Received By: 4t J(�14' a1' t{ cc 'M (�� L f <br /> 10 <br /> REQUES'C FOR ANALYSIS <br /> Sample No. Sample Location Dale/'time Collected Samplc Container Preservative REQUESTED ANALYSIS Detection Comment <br /> 3 Type 'type/Sac Limit <br /> /61 1'l Q`! �1 ,Q:7 :3u! ( G ,r�f ✓/: - c �(�fc� ��,; Vii., f'!I'� .' •�3°� P/�'N` 6). '1 <br /> Ni b,1�1 j /O 13:00 <br /> iL! q — Zt� t ► /:i: Ll <br /> 57 tl / S=�% it I1 fi Lf !f tl LI <br /> PJ- lL�1 �t v a% . Y �l� lfi GAJ�✓ �1 I .X !it r.-fw f' 1, -o r" ,' l <br /> 13-3 <br /> White-Terrasearch Project File Yellow-Terrasearch Field File Pink-Laboratory Copy <br />