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ICHAIN OF CUSTODY RECORD ' Bill o 1445 e tet,8071 N , <br /> Sherwood PO Box g der Avenue <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 AttennoPhon <br /> C O R P O R A T_1 O N FAX (209) 667-2581 E'7 �' G�{ri 2 Page I of <br /> :;d <br /> Job Number PO 3 PrrtName <br /> r Mff' <br /> Sample ignature) Site Address <br /> Y �o� 19ym <br /> Q� <br /> \"§ <br /> PE <br /> SAMPLE LOCa�TION DATE TIME NUMBER GRAB OR SAMPLE , <br /> NTIFICATIO MTH/DAYNR HOUR/MIN O ( Q <br /> ( ( ) ( ) CONTAINERS COMPOSITE) MATRIX �Q ,�� REMARKS <br /> r' oZ.� �4�fd3 10;3-7 <br /> v 8 y` L/0,I <br /> t/hV103 10- -Sol/ x <br /> 3 - 3 YN163 15 2 3 <br /> 14 _ c /j3 15 31 <br /> Relinquished By (Signature) Date/Time Received By (Signature) Date/Time TURNAROUND TIME <br /> � 1��f <br /> Relinquished By (Signature) DatelTme Reserved By (Signature) Daterrime �� � 24 HOUR CI <br /> � 3 � Y�i0 o 48 HOUR ❑ <br /> Re"uisheg By (Signatu 6ateffime �( we! IV By (Signature) Datefrome 5 DA <br /> STRIBIJTION Original-Acoompanies Shipment Canary Copy Sherwood Pink Copy Sampler NOTE Samples are discarded 30 days after results are reported unless other arrangements are made <br />