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------- -------- ------- ------ <br /> k <br /> Bill To: <br /> CHAIN OF CUSTODY RECORD <br /> Sherwood 8071 N. Lander Avenue <br /> P.O. Box 937 <br /> Hilmar, California 95324 <br /> — <br /> Labs (249) 667-5258 Attention- OSS Page --L of Phone: <br /> C 0 R P 0 R A T 1 0 N <br /> FAX (209) 667-2581 Aift,!2e <br /> Job Number: Project Name <br /> Samplers:(Sig lure) P.O.Number: <br /> /10 <br /> SAMPLE SAMPLE NO. <br /> DATE TIME SAMPLE INFORMATION OF REMARKS <br /> NUMBER TYPE CNITRS <br /> Z! /w- <br /> Relinquishevy:(Lssippatu* Daterl-inte Rec/lved By:(Signare) D419/Time hip Via: <br /> Relinquished By:(Signature) Date/Time Received By:(Signature) Date/Time <br /> TURNAROUND TIME: Date <br /> Relinquished By:(Signature) Date/Time Reeeived By:(Signature) Date/Time ❑24-HR N 5-Day 0 10-Day <br /> DISTRIBUTION:original-Accompanies Shipment: Canary Copy-Sherwood Pink-Sampler NOTE:Samples are discarded 30 days after results are reported unless other arrangements are made. <br />