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s <br /> M PDS <br /> Services, Inc <br /> CHAIN Oi' CUSTODY �,� z <br /> SIIE HANE 6 ADDRESS ANALYSES REOUESIED IuRH AROUND TIME <br /> SAMPLER <br /> ale,c13 <br /> WITNESSING AGENCY <br /> NO A` x REMARKS <br /> or SAfIPt I NG <br /> SAMPLE P� <br /> ID NO DATE TIME SOIi u�iCTr� CORP [ONS IULAVIUN <br /> W Ia ,J,� Icy x010n ([ Q 13 <br /> 17 <br /> -7 'Y x V <br /> McJl3 _ —_ <br /> )rf <br /> c3X Ilre following MUST HE completed b the laboratory accepting sorgPles <br /> Relinquished b (Signature) r�1�� 11{oK civcd by for si��nottuc ��34 g T' y <br /> � - D c.� onnkysls. <br /> 'Itv V Nove rill snnitles received <br /> Rllte) Dote for analysis been stored In Icer <br /> lnquished byt (51 naur /Tian Received by (Signature) <br /> 2 uilk samples remntn refrigerated until enoiyied7 <br /> Lz� " - <br /> k61 Ingi�lshed 6yt (Signetural Date/lime Received by (Slgnature) 3 Did any sanjA es received Ior rinnlysts have bend space? <br /> 114. ^5 74 were samples to appropriate containers end properly petkagedT <br /> Relinquished by' (Signature) Hate/Tln+e Received by (SignoLrrre) Y <br /> Stgnature )itis D to <br /> 2fq) tirvrw�Vl l}rivr tion. IIM) <br /> (nnuml Cildnrnlr9h2r1 <br /> le 1 Sll)ff)2 Strx) I �► Slrt(0I7(10)2 <br />