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CHAIN OF CUSTODY / AASES SES REQUEST FORM <br /> Project No 2L\55 Field Logbook No Date ZZ2-%��'). <br /> Serial No <br /> 9823 <br /> Project Name � Y _ � Project Location S' ��� fc'�11' L� <br /> Sampler (Signature) v ��,,� ANALYSES Samplers <br /> SAMPLES Na OF SAMPLE <br /> °� °��,�� rya O�4 J`"�� ✓� <br /> LAB SAMPLE P QP <br /> SAMPLE NO DATE TIME CON— �� k y Q' REMARKS <br /> NO. TAINERS TYPE �J <br /> C) 1 <br /> RELINQUISHED BY DAT TIME RECEIVED BYDATE, T] E <br /> (Signature) f(r� i j (Signature) <br /> RELINQUISHED BY TE TIME RECEIVED BY p TE TIME <br /> (Signature) Z' q I p, (Signature) J �3 <br /> RELINQUISHED BY DATE TIMI RECEIVED BY 'DA6TC TIME <br /> (Signature) ( (Signature) <br /> i <br /> METHOD OF SHIPMEN TO TIME LAB COMMENTS <br /> Sample Collector LEVINE-FRICKE Analytical Laboratory <br /> 1900 Powell Street, 12th Floor �N <br /> Emeryville, Ca 94608 <br /> (415) 652-4500 <br /> Shipping (White) Lab Copy (Green) File Copy (Yellow) ld Copy (Pink) FORM 86/COC/ARF <br />