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BdIT° <br /> %oHAIN OF CUSTODY RECORD <br /> Sherwood 'PO1Box 937der Avenue <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention Pno <br /> C O R P O RAT ! O N FAX (209) 667-2581 r� p Page 1 of ffl] I <br /> Job Number PO # Project Name <br /> Samplers (Signature) Site Address <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE SAMPLE �' <br /> (IDENTIFICATION) (MTHIDAYIYR) (HOUR/MIN) OF (GRAB MATRIX <br /> CONTAINERS COMPOSITE) � REMARKS <br /> OW u 3 5 I q f So I ( 1( x <br /> I F <br /> Sol / < .� <br /> " , l j Sail X <br /> - QV11614 3 3� Sol <br /> I <br /> Relinquished By (Signature) DatelTme Recenred By (Signature) DateTme TURNAROUND TIME <br /> /6l yo A lu,' cid`11 b> <br /> Relinquished By (Sf nature) DatelTme Rece� d By (Signatur Date ime 24 HOUR [] <br /> !6-1a03 �� Y7 , �/, i721a3 48 HOUR Ll <br /> Rel cashed By (Signa e) Date�me 4Z eceiv d By (Signatu41Z,1411 <br /> re)) Date�me 5 DA� <br /> 7'/ � 1 17103 :( 41Z,1 1 1 INTO, / -;)00 \ <br /> DISTRIBUTION Original-Accompanies Shipment Canary Copy Sherwood Pink Copy Sampler NOTE Samples are discarded 30 days after results are reported unless other a rahgements are made <br /> r' <br />