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i • . _ <br /> Clearwater Group <br /> Subcontracted Microbiology Assays <br /> performed by <br /> CHAIN OF CUSTODY FORM � '3 — I U <br /> Project Name: Project No <br /> B��5 Zrucic��.s Clearwater Purchase Order/LOGIN# <br /> (7�C. I?-)s3 <br /> Clearwater Client Organization, <br /> Clearwater Project Manager� <br /> Address to Send Results ,A er:Skxc((&— <br /> Client Fax for Sending Data Client Contact/Project Manager <br /> Client Tel for Follow-up Client Sampler/Recorder <br /> Aerobic Anaerobic Anaerobic <br /> Hydrocarbon Total Hydrocarbon rotal Anae iron Sulfate <br /> D Time Solt Water D raders H rotro hs De radars Hetero s Red era edac Reducers <br /> I'vluJ-I �� a3 f o V � K � Do NH Pae 3 S S ltlde Fe <br /> rAVJ-4 153 '� X <br /> J <br /> ul' Sad f x X x X, <br /> Chain of Custody Record Signature of this form constitutes a firm Purchase Order for services Payment Rel quished b Date/Hr yin nt DUE on Renarttng Date <br /> Received by Date/Hr <br /> Received for Received <br /> Lab by bate/Hr <br /> CytoCulture T 510-233-0102 249 Tewksbury Avenue <br /> Lab Service Fax, 510-233-3777 Point Richmond, CA 94801 <br />