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Mb 9 <br /> CHAIN OF CUSTODY / ANALYSES REQUEST FORM <br /> Project No. : el-I Field Logbook No. : Date: 7/ Serial No. : <br /> Project Name: h Project Location: Q 11724 <br /> Sampler (Signature) A E Samplers: <br /> P L E X01 � .(� �� �� D <br /> SAMPLE N0. DATE TIME LAB SAMPLE NO. OF SAMPLE REMARKS <br /> NO. TAINERS TYPE <br /> 1 A A,V <br /> ' D14 <br /> Varava <br /> S A C� G„{ 1 <br /> S <br /> S 8 <br /> J o rte' e-- <br /> � I <br /> RELINQUISHED BY: f L E RECEIVED BY: DAT TIM <br /> (Signature) (Signature) <br /> RELINQUISHED BY: ATE t f I RECEIVED BY: E TIME �- <br /> (Signature) _ ' r �j (Signature) <br /> RELINQUISHED BY: r' ATE TIME RECEIVED BY: DATE TIME <br /> (Signature) (Signature) `./ <br /> METHOD OF SHIPMENT: DATE TIME LAB COMMENTS: �1� �l SIS Y1 1 V,Or[`t r&T <br /> Sample Collector: LEVINE-FRICKE Analytical Labo66ratory: 0\ / <br /> k4, -6_�-5ee <br /> Shipping Copy (White) Lab Copy (Green) File Copy (Yellow) Field Copy (Pink) FORM NO. 86/COC/ARF <br />