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CHAIN OF CUSTODY <br /> AlVD All AT TIS REQUE,S `DOCU.tV1E.cV7, <br /> p e ° <br /> .�7 <br /> Client: tunpler(5)- 'Rush Analysis:a Days 2 Days ?Gilr� <br /> S — <br /> 8uhject to surcharge <br /> Customer Number: <br /> Comp Sampler Set Up Date Tftne. QA/QC.report required: •yea no f <br /> Address: � Time: Mile e: I£yes,To: State ClientDther <br /> f Lab number: �� �'��! <br /> I <br /> Phone: — - <br /> FA.X; 4228 <br /> Project name; $' W w <br /> -e � <br /> Contact person: _ - z a3SAMPLE :FNF0RivLvri0N <br /> I <br /> s <br /> 3 <br /> = 5►r Li I <br /> Saurple Date Time r 3 n m j <br /> Atiluvi6er Location Description e 3 <br /> sample Sample <br /> f—119 <br /> aim/ <br /> Relinclui3heci by. Dace Ti�yte r Received by lJate� <br /> Relinquished by: (Fate Time— Received by: Date Time <br /> Retinquished by: Dwe Time Received by: Date__ Tuna <br /> PPSECISION E RO TECD 545 E.Clevel.an(i,Shite A'Stock toD CA 95204*Telepho-ne(209)462.0892 h FAX:(2I19)4 62-793 5 <br /> C. a t --�) "I L=1' r -I tz—:) L..t " L-:--1 L—J L L.J' �i Lzr j " C- l L::'i L"z'*[ <br />