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W" 10 CHAIN OF CUSTODY RECORD Page I of <br /> Environmental and Geolechnical Consultant 555 Montgomery Street,Suite 1300,San Francisco,CA 94111 Ph 415955.90401 Fax 415.955-9041 <br /> J( 2 Theatre Square,Suite 216,Orinda CA 94563 Ph 925-253-49801 Fax 925-253-4985 <br /> 501 14th Street,3rd Floor,Oakland,CA 94612 Ph 510-87445001 Fax 510.874-4507 <br /> Site Name � ��-�-Z �.r4 <br /> .lob Number 5'1-7 O) -.ILO Analysis.Requested� <br /> Protect Manager%Contact <br /> Samplers <br /> Recorder(Signature Reqwred) tu QL <br /> No Containers <br /> Matrix &Preservative p <br /> y <br /> Field Sample :�; o ro u <br /> Identification Na - Date;� 3tma Lab Sample No m = SURnemarks, <br /> y ` 2 2'L-o $SD 1I 1W <br /> TA 1yS-o-Jo lots <br /> TRS- co <br /> %310 ! <br /> T07-5p-4-5 1410 X i <br /> - 7 <br /> 're io' 16 t40l� <br /> I O � ZZC � <br /> i <br /> Relmq ed by (Sig t re) Date Time Re b Signat ) Data Time <br /> �rLr7 e3 !6 <br /> Relinquishedbyby (Signature) Date Time ed by i ure) Dati Time <br /> I <br /> Relinquished by (Signature) Date TT", <br /> e Received by Lab (Signature) Date Time <br /> Sent to Laboratory(Name) {+ice a k, Method of Shipment Labcouner Eked Fac E]Airbome OUPS <br /> Laboratory Comments/Notes Hand Camed[]Prorate Couner(Co Name) <br /> White Copy-Original Yellow Copy-Labo/�ratory Pink Copy-Field COC Dumber 002878 <br />