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CHAIN OF CUSTODY qau v�� Page �of , o <br /> a N <br /> a w <br /> Lab: � �. U') <br /> ro <br /> TAT: <br /> Report results to: ms <br /> Name Philip McLaughlin Project Information <br /> Company bureau Veritas North America, Inc. Project No. 33113-013018.02 <br /> Ming Address 2430 Camino Ramon#122 Name Proposed FedX Facility — <br /> Ci State,ZipSan Ramon, California 94583 Location Trac , CA <br /> Telephone No. (925)498-6512 <br /> Fax No. (925)426-0106 Anal ses Requested <br /> v <br /> 0 <br /> Special instructions andlor specific regulatory requirements: p <br /> m <br /> Ln cv <br /> co <br /> > f (0 co <br /> o <br /> E <br /> � <br /> DODas co <br /> Date Time Matrix/ No.of M s uJ v CL W Sample ConditionlComments a, <br /> Sample Identification Sampled- Sampled Media Conts. ia- ° m o O w o a_ <br /> BV-C3 5/23113 t (5,8 Soil 1 Comp C see above) Ice <br /> BV-C4 <br /> BV-D1 D D D D D Comp D <br /> BV-D2 .Z;'-D <br /> BV-D3 3 5' <br /> By-D4 2.3o <br /> BV-E1 !2�P' E E E E E Comp E <br /> BV-E2 <br /> BV-E3 (360 <br /> BV-E4 S IT <br /> Collected bYe iA I Collector's Signature: <br /> Relinquished by: imer, z � Received by: Date/Time �� Z <br /> Relinquished by. ateUllme Rece#ved by. Date/77me <br /> Method of Shipment: Sample Condition on Rcpt: <br />