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MM MM M M MM <br />} CHAIN OF CUSTODY � RD <br /> keological Audit Services, Inc. nate � Ls'a ! 2 Z <br /> 9 mot <br /> 'r <br /> r <br /> Client PROJE MANAGX <br /> R <br /> -&a 1� <br /> PHONE NUMBER <br /> j (2,01) 9sG oZ�� <br /> PROJECT NAME SAMPLERS i cna 'Ie;�� <br /> Am t — — <br /> SAf.f,�c ;vaE <br /> SAMPLE LOCATION DATE TIME _ WA7EP AIR SOLID NO,OF TESTS <br /> NUMBER DESCRIPTION COMy7 Grab. CNTNAS REOuiREO <br /> 4- weU, 44 & <br /> 94- 615 <br /> B -30 6/23 <br /> i <br /> i <br /> E <br /> i <br /> Re1in sn tty Sign lurk Rec ved b :( gnawrel DatllTim! <br /> Relinquished by:(Signatur,t) Received by:(Signature) I Date/Time <br /> ---L— <br /> Rehngeushed by:(Signature-) Received by Mobile Laboratory for held analyses Oate/Tim! <br /> (Signature) <br /> Disoatched by_(Signatusel Date/Time Received for Laboratory by: DatelTime <br /> i <br /> Method of Shipment: I lereby authorize the perlormance of the above ir+dicated work. <br /> Special ln3!ructions: <br /> SOURCE_ Aaapied from U.S-EPA.1965 <br /> OCr41d0 <br />