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ENVIRONMENTALv� Ew� CHAIN OF CUSTODY <br /> 14"WIN, gll'IdT coin <br /> b rate 1 Copy <br /> 33458:06l021Z068 TEST DESCRIPTION - See Reverse side far Container,preservative and Sampling information <br /> Client: "1150 Anderson&A,,d tes <br /> Address: 902 Industrial Way <br /> Lodi,CA 95240 <br /> Phone: C209)367-3701 Fax: (209)333-8303 <br /> Contact Person: Ned Anderson a M4 <br /> project Name: SCEP J,y14Y/4a w <br /> Purchase Order Number: E Y R <br /> LG$ D $OS1i'y ca = s <br /> Quote Nmnber: <br /> rc <br /> E <br /> u : 7zi h O <br /> a� m <br /> a <br /> Sampling Fee: Piclvp Fac- 5 i c Y a vas A <br /> Compositor Setup Date:—1-1— Time: 1 E <br /> o a o ' <br /> Lab Number: $2$ J l09 <br /> 3-9574 `o rn 'e' g,� E <br /> Slump z o o F a)` > V„ <br /> Nr� Location Descripdon Date Time y` 6 u B < Ik <br /> Sampled Sample[ e= $ R to� <br /> 0 Travel Blank G LBW 2 <br /> ` 43 a1CL 3.0� j31q G DW <br /> 2 1 <br /> Remarks: <br /> linquished Date: Time: Relinquished pare: Time: ed Date: Time: <br /> }ot r3�t1 f//��oB f7od <br /> ^'m BY: Dare: Time: Received By: Date' Time: iv - y: {{ Da Tam: <br /> /09 /330 �iy` �ag/70 l� <br /> Corn rate ONfces&Leh t <br /> OH'rs?&Lab t <br /> .853 Cnrpara.C Sheat 563 F&M-Lnd DAv OFy 1' Field Office <br /> C K <br /> Santa Paula,CA 93060 25D3 Stagecoach Road 563 East tintlo Avenus Visalia,Calr<omia <br /> TEL= (805)392-2000 Stockton,CA 95215 Chlcn,CA 95926 TEL(550)734-947; <br /> FAX: (806)525-4M TEL: (209)542-0182 TEL (5s3)243-51118 Mobile (559)737-2399 <br /> FAX: (209)942-0423 FAX: (5301343-3W7 ccv raco.von-eeoc <br />