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r ' <br /> t <br /> KAPiREAL1AN ENGINEERING, INC. <br /> (w CHAIN OF CUSTODY —1 <br /> ANALYSES RTDUESIED �{ TURN AR"r TIME: <br /> SITE NAME d ADDRESS <br /> SAMPLE f l <br /> IVIINEESSING ACENcr <br /> I I I { It E p A R K 5 { <br /> f ! ! I I I I I o0, SAMPLING I / Illy/1 I I I <br /> SAMPLE I I I { LOCATION <br /> I I I } <br /> ID NO, I DAZE I TIME ! 501E IWA11RIGRAilCOMP{COWT.I <br /> � I I I S I 1 � { ^ 'N•� k �{--f---4--I <br /> �l.._—.� 4--i--�♦—� I i l I 1 I l I I I <br /> I I I I { ! I I I <br /> JIN <br /> I eceiv signature) <br /> ed <br /> 11De (ollowing MUST BE ta++pleted by the Laboratory accepting Samples <br /> 5' nature) Da;e/Time for analYsist ! <br /> l inW ` <br /> t���\ I� �•��ft ! 1, Have all Sam <br /> received f r nalysis been stand in ice? k <br /> ��, Date/time I Received by: (Signature) I <br /> (Relinquish by: (Signature) <br /> 1 12. vitt Seaples remain rcfrigcr t tit analyzed' ! <br /> I 13• aid ery Sd:ples received (or analysis have head Spate' 4 <br /> (Signature) I Date/Time { Received by: (Signature) i /� <br /> !Relinquished W (Sig I iatc c Diners and property pactagecP I <br /> I j L• Vere samples in awropr f <br /> wpatelTime I Received b/: (signature) I <br /> IRelirished try: (Signature) lt[le Dale { <br /> f { 1 Signature <br /> f �._.t_ <br />