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Trea"EM10 CHAIN OF CUSTODY RECORD Page ofL <br /> Environmental and Geolechnical Consultant 555 Montgomery Street,Suite 1300,San Francisco,CA 94111 Ph 415955.9040 l Fax 415-955-9041 <br /> 2 Theatre Square,Suite 216,Orinda CA 94563 Ph 925-233-49801 Fax 925-253-085 <br /> 501 14th Street,3rd Floor,Oakland,CA 94612 Ph 510-87445001 Fax 510.874-4507 <br /> Site Name ` 'r <br /> Job Number O aiysls�Requested <br /> Projepct ManageAContact d Q rw-5 <br /> CL <br /> Sam lers Q ' <br /> Recorder(Signature Required) No Containers <br /> Matrix &Preservative � <br /> q� , x <br /> .tv <br /> Field Sampled r, t � e�' <br /> Identification No" ' Date,. Time f` Lab Sample No " v, z° EffiRnema". <br /> [AL2-G('a� �s I1tYJ X X `t3 <br /> Ila 12 ► � � �,,� � <br /> wit) <br /> x <br /> I 20D i <br /> 121 X f <br /> a7 -� 1237 xV,A 14-A <br /> �rzzt,- l xe <br /> t5 3 <br /> �2 -fR Z2 Z <br /> R2 l2Z <br /> � I <br /> Relinquished by nature) Date Time R ed by (Sign ) Date Time <br /> 9 '05 `b <br /> Relinquished by (Signature) Date Time ceived ature Dat Time <br /> Relinquished by (Signature) Date Time Received by Lab (Signature) Date Time <br /> i <br /> Sent to Laboratory(Name) Method of Shipment ,,,,0�Lab couner []Fed E. DAirbome UPS <br /> Laboratory Comments/Notes Hand Camed❑Pnvat4 Courier(Co Name) <br /> White Copy-Original Yellow Copy-Laboratory Pink Copy-Field COC Number Q Q k 8 8 4 <br /> A✓rut�� �7 ��� I <br />