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O � V <br /> r' <br /> I <br /> SAMPLING/ANALYSIS REQUEST AN(m,RAIN OF CUSTODY RECORD <br /> Project N6.: 310 .01 Requested By: Tom_ RIPP _ P.O. No. <br /> REQUEST LABORATORY REQUIREMENTS CHAIN OF CUSTODY -i <br /> f, SAMPLE TYPE.1501ESAMPEER'S SIGNATURE <br /> CONTAINERS %CONTRACT LABORATORY ; <br /> SAMPLE I.D. PARAMETERS SIZE/TYPE QUANTITY PRE& LAB DUE SAMPLER SAMPLE DATE RECD BY DATE <br /> DATE COMMENTS <br /> PR -sell, ill 61111 — <br /> RECD <br /> F-f 4 r -6�2 was coi+,kerosene xH/90 �I/r]wr/lf <br /> 14rE rr.+9 I N��rJ "n.RlPla <br /> i n r, fk <br /> T <br /> 10 0 <br /> -2 5-6�2 wash aif,kcraSen x N p rC7[(fr(�•:.n t'..»711 i7AjOirwIi�n_�ti• J <br /> eA4 So( rr f c�3-lill <br /> AU-2 <br /> !0-!!%z X5014 v j /r n jr v i & <br /> aS, ICBG ly <br /> �•' �� <br /> JjTEK i 1,ktrasen n 10 S ��+ <br /> Q U-3 . 5-6%2 <br /> y ✓s , O i <br /> /r y rr <br /> ilJ� el,kansanc.EM 2 ( /I (r tl rr e�.•lG, <br /> - <br /> 2 Ltrni, vi <br /> r t �-2 (1j) <br /> I� 5�'3_�O� e,+,Errr•esen�,EA4 \ } ' <br /> i » <br /> s P-14 (0) <br /> L <br /> SIGNATURES: `I"^ vz-qo-vS+0, <br /> Ad-r" Pb r>.(� ror'29Igo <br /> Relingy shed By IS' e) grgenixatian flute/Tlma Ra v y(SI atura} Organ z ]on Dato/Tlma Turn Around Time _ x <br /> ec ro�z rasa. ��%� <br /> r 1 �d r (Circle Choice) -rAV44Q� <br /> fielinquis v fly{Sip rei Organizagon - +iacalva y( Ignatur Orga izalion Date/Time 24 r - <br /> 48 Hrs <br /> �'sh�cl(�7B is g�na viol Organiz tion Dale/Tlmle Recol i For Lob or By[Signnlura} , Date/Zimo 5 Days <br /> /� u 10 Days <br /> ' y ya <br /> �vl,r 1� (1n�r. n, <br /> C7) <br /> Zo IQSGn Ety �ri'P14 Bolo <br /> PACIFIC ENVIRONMENTAL GROUP, iNC. l <br /> I <br /> I <br /> I <br /> I <br /> I <br />