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J`eS CHAIN OF CUSTOD <br /> ENVIRONMENTAL PROJECTS MANAGEMENT. Date' —Page-gm—of S . <br /> 217 Primo way.P.O.Boz 576185 . Modesto,CA 907 <br /> PROJECPI.D. 4 A OL ANALYSIS REQUEST # <br /> ADDRESS a 75- 1 Y 7 rac g T T T B 0 M UA OR R O O <br /> P P T & F <br /> 11 �P E RL LG G T L <br /> L L H T GO IA A A U U <br /> SAMPLER'S N .g H H G E G A. A C A N N L B <br /> G D & X <br /> BA TI I L N <br /> SIGNATURE B S E B L S C E E A <br /> T O E L A L N <br /> TELEPHONE NUMBER E Cd,Cr N E D E E <br /> S A A R <br /> X Pb2n D D S <br /> SAMPLE I.D. DATE TIME MATRIX Ni <br /> SS _3 t ar Soil Ater K . n X � • - <br /> 2- ater K K )C j <br /> 8 y� <br /> 4!6water X X X <br /> S8 ater X - K x <br /> - . ' <br /> Soi ater )'( X - <br /> s <br /> LABORATORY INSTRUCTIONS/COMMENTS: <br /> RELINQUISHED BY: RELWQUISHED BY: RELINQUISHED BY: <br /> R.A. JAcols <br /> Tum-around Time(Circle One) E to rated Kama Printed Name Printed Name <br /> Same Day 24 HIS. 48 Hrs. 72 Hrs. gormal COQ mPa�nom^ Comby Company <br /> Signature Signature Signature <br /> Time :/0 Date fc'l" y3 Time Date Tame Date <br /> Cir VED B :. RECEIVED BY: RECEIVED BY: <br /> rinN me , Printed Name Printed Name <br /> ca. <br /> ANALYTICALJ Company company <br /> LABORATORY_J L A V A L V 77 C A-L <br /> QTY `f�t� �� � _— Signator Signature Signature <br /> � sTime 5:L* Date Zfl M? rune Date rime Date <br />--------------- <br />