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-7 <br /> Chain-of Custody Number: <br /> S)ECC)IR, Chain-of Custody Record <br /> QAdditional documents are attach6d, and are.a part of this:Record. <br /> Field Office: ir4N,"eA <br /> Address: 175 IV — -5 Job Name: k& <br /> A�O Location: 11,040 451 <br /> ke-rnad, <br /> Analysl's' Request <br /> Project# -r- 714--064 -of Task#_L46 �,E <br /> Project'Manager 7,r-k,, &Ieq- <br /> Laboratory— Y e-A P_ ,,I pI 2 5 <br /> Turnaround Time 56,n= X cn 1; ;5n <br /> L <br /> 912 <br /> INE <br /> Sampler's Name <br /> CS <br /> E 's E <br /> t H <br /> 'Z/'���� 0 <br /> Samplers Signature 7' " q E <br /> =10 U�) 'E Comments/ <br /> CL (L z <br /> 43D <br /> 0!, <br /> -8 W1, Instructions <br /> Sample ID Date Time Matrix <br /> C1 <br /> /0 Lo 3 <br /> /-f LAI <br /> /I vi(o --a0 F'. ]HOLD <br /> 900 <br /> W4 A 5� <br /> 0 <br /> /4 U/(a 'Yo 71o7 WoL 6 <br /> 140- <br /> M V1,6 — 4 5 <br /> do[- V 4q I <br /> AIW6 - 60 <br /> Special Instructions/Comments: Relinquish6d <br /> Roo iv d by: Sample Receipt <br /> Sign Sign Total no.of contaln'ers- <br /> Print 7,7,/ Ar-,"AA Chain of custody seals: <br /> 110L,0 Print <br /> All 716 6- Corppany :515&4 IC — Compan Rec'd.In good condition/cold: <br /> Time _QAL&_4_) Date 17-79 Time ::50Date.t.7-11 Conforms to record: <br /> Relinquished by: Received by: <br /> Sign Sign Client: 6- ip <br /> Print Print Client Contact;'TIA, llwe,� <br /> Company Company <br /> Time Date me Date Client Phone:(W- <br /> Ti <br /> '6A CUSTREC A.UPS <br /> Date: page of <br />