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i i i i i i i <br /> CAST41 ANALYTICAL LABORATORY _ , < < <br /> ,_.T� CHAIN OF CUSTODY* <br /> Location: 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No. 2079 <br /> Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 PAGE—Z—OF—/— <br /> Phone: (2091 384-2930 - Fax: 1209) 384-1507 n <br /> w <br /> CUSUDMer: / REQUESTED ANALYSES Method of Shipment: 6 <br /> Address: , • ;> WX <br /> City/S1ate/Z1P:S a Notes; ~ <br /> Phone / FAX: ,L l w � Iw q U � ° w n <br /> � ad <br /> Proj # / P.O. #: 'y CL ` 3 fl - 0 � <br /> ReportAttention: ,�, �, a o N <br /> Sampler Signature: a w w <br /> H <br /> Printed: 9 r Z <br /> Lab tDR SAMPLE ID DATE TIME DESCRIPTIONILOCATION 66 09SERVAtIt}NSIREMARKS <br /> MW-4/71-104 <br /> N <br /> bP <br /> w J/:1/J 01 <br /> V <br /> tD <br /> i <br /> $ C� <br /> . <br /> L <br /> G <br /> F <br /> . N <br /> GD4a CONDITION PPR PRIA <br /> r;}, <br /> HEAD SPACE ABS ONTAINER `O <br /> VT <br /> wntainern oubrrmieW to <br /> Printed Name D to Time Company Name the laboratory <br /> elinquished by: / "f I Note:All special requests(e.g.quick <br /> tum times}must be cleared through <br /> aceived by (,` r2 1 `' m authorized laboratory personnelel <br /> . <br /> elinquished by: <br /> Recehred by: w <br /> Relinquished by: RESULTS DUE: @ <br /> Received by: VERBAL j..- WRITTEN N <br /> to <br />