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w <br /> SPARGE -ECHNOLOGY, INC. - J � ;HAIN OF CUSTODY RECORD <br /> Analytical Laboratory Phone:(916)362-8947 C.O.C. No. 25796 <br /> 3050 Fite Circle,#112 Sacramento,CA 95827 FAX:(916)362-0947 Page of STAL Invoice Number: .' <br /> Company: Apr-y- l` -C Phone: ANALYSIS REQUEST <br /> T (An W � <br /> Project Manager: _F01"Y FAX: REMARKS: Sampler's Name: <br /> Report Address: -)61q.1 - - Billing/Name&Address: <br /> St 1i t: !©C{ viJC LCA <br /> r" <br /> All None Some <br /> Project Name: ( Le 'C1,20t.Qt Prolect/Job#: y� OK OK OK WET STLC <br /> Cooler Temp. °C <br /> Project Location: _ PO.#: Sample Condition TCLP <br /> pH <br /> Preservative TCLP Total <br /> Sampling Container Used Matrix ,9 TAT <br /> all <br /> _ o <br /> O N <br /> co <br /> r <br /> N O � <br /> CL) OLO <br /> r N a <br /> co O d C6 z N <br /> Ulco <br /> O 4N O V h d <br /> O " N 2 � 4- <br /> �.j O <br /> U m LO d }I ) L <br /> O N a = A7 a �. LC -' U <br /> Lf) C> NO C} N Ifs <br /> N O O m co 0) _O O O O O 0 o� ,� N y <br /> Q ) L (h N O O O O N N O ro _U N <br /> C) 2 `m a p O d m ao c2 a_° m J <br /> N E J N O O O O N N 6 - .. .- "D. <br /> V) E L: z a) X- '0 co c° cn c0 to c O d c v `� <br /> O J N L O L O L w F- d 0. d li d Q¢.. O N (� f^ ti C L -O <br /> NO. SAMPLE ID Date Time m r N O z O rn ¢ o m m w w w w w w z o m y v c"n cc' z <br /> 2 <br /> 3 rllvo i <br /> 4 vnUJ3 ! � <br /> 5 IVl W <br /> 6 <br /> ,r <br /> 8 w IJ <br /> 10 <br /> ReIin shed R d Relinquished by: Received by. <br /> ❑at : 1 -2t' UCS Time: 4,200 Date: C - =Willa Time: a Date: Time: Date: Time: <br /> PLEASE READ REVERSE SIDE FOR TERMS AND CONDITIONS <br />