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Bill <br /> .(_1HAlN OF CUSTODY RECORD �J <br /> Sher.wood 8071 N. Larder AvenueP.Q. BOC lif <br /> LJ 0. Hilmar, California 95324 ' <br /> Liths (209} 667-5258 AttentioP Pae of <br /> 60 R P O R A T I O N FAX (209) 667-2581 �1`� 6`�0 <br /> JobNu ber P.O.# Project Name <br /> amp! :(Sig atur Site Address <br /> SAMPLE LOCATION. DATE TIME NUMBER TYPE SAMPLE } y <br /> (IDENTIFICATION) (MTHIDAYNR) (HOUR/MIN) OF (GRAB OR A, `0 Q`r �Oi <br /> CONTAINERS COMPOSITE) MATRIX �• Q �!v �+ .. REMARKS <br /> 3 44 1Ji <br /> V 5_. 5` S ti� X X <br /> / 3 i> <br /> I •. <br /> I ' <br />' Relinj isfied By: Sign u DatefFime Receive B :(Signature Date�me <br /> �•� ,�®2 � �j TURNAROUND TIME <br /> Relinquished By:(Signature) Date/T a Received By:(Signature) Date/Time 24.HOUR ❑ <br /> or <br /> 48 HOUR ❑ <br /> Relinquished By:(Signature) Date me Ptceiv <br /> d By:(&gnature D teJTi a DAY,4/r !� 4� .36 /D y 11,r` �Lsc"l I 4' 3 3 �'1_�i <br /> D TRIBUTION: Original-Accompanies Shipment• Canary Copy:S erwood Pink Copy:Sampler NOTE:Samples are discarded 36 days after results are reported unless other arrangements are made, <br />