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-T or acacttarr - A.l}.D, 2500 Karr Drive, Sluciton EA 95206 (209) 944-9711 <br /> Appendix III <br /> SAMPLE LOG <br /> �4�44444444444444444444444444 <br /> 4444444444444440044►OH4K44444444444444444tir4M�4444ati444444644w444044044444444444ntiv44�yti4 <br /> I Date: I I _ personnel: <br /> Location: <br /> E 3 "nrab <br /> Scheduled .____ <br /> h..L.Ld E ] Jliai�nattnc:°Q j rrograe: <br /> [ I Cosposite Started: I 1hr Retreived: 1 <br /> E 3 Ilahual. Tize between sas les: hr; <br /> P Birt YoIuee per saaple; 81 <br /> l 3 Autocatic Sasples Per containers Yoluae per container: el <br /> Total nueber of containers: Type of Saspler: <br /> Saaple Containers: Description: E I-Secured E Mnsecored <br /> t 9-Acid gashed E 3-Asad/Solrent Vashed <br /> i 3-Did E 3-Did not contain a preservative { y <br /> �4�4a"d444b44444bbti4 <br /> 44444M4444p44444y4pOgg44 g444444444446G44tgqry0444bbp44qp444444440�404yq44q444644"4*4* 4044491x4 <br /> I I o <br /> Tao Nusber bate Tike Lab I.D. Contents <br /> 4444444M444444444►4M44444444444444444444444444444444444444444ti444444444444444444M44.4444444444444�44444444r444444444444 44444 <br /> III.Sanplefsf Relinquished by: <br /> for: ; Received by: Date: J I <br /> for: Tine: hr <br /> ♦444444►4444444444444444444444444444444444444444444444♦4441444444♦44444441444L44444444444444444444444444.4444444444444441 <br /> Saaplefsf Relinquished by: ; Received by: <br /> for: for: Date: I I <br /> Tine: hr <br /> 444444444444444444444444444444►44444444444444444444444444444444444444444444444444444444444►4444444444444444444444444444444444 <br /> Fora CCR/l rev 09/04/86 Ieh 7 <br /> Sequence Na. <br />