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CHAIN OF CUSTODY z Page I of <; <br /> - r <br /> Lab: fY',c( <br /> A s TAT: SGVn.i�i�✓t� <br /> Report results to: <br /> Name FiL`fSS� pL4{.�. 'DJN Project Information <br /> Company Bureau Veritas Protect No 11666- 061632-t-3- 3 <br /> Mailing Address 6920 Koll Center Parkway, Ste. 216 Name h'1 g bYo <br /> City, State, Zip Pleasanton, California 94566 Location SF, L ,611 <br /> Telephone No. (925)426-2600 <br /> Fax No. (925)426-0106 Analyses Requested <br /> Email: s u.. bz a .wu�tnr}a5•r-sw. <br /> Asr+ �Sln-6, ev .►x�eu�+Jt+i�c..,.cavv, v <br /> a <br /> H <br /> Special instructions and/or specific regulatory requirements: (3 <br /> v LUU Format for Geotracker <br /> y Yes No <br /> Date Time Matrix/ Ni) of S Sample Condition/Comments <br /> Sample Identification Sampled Sampled Media Conts. <br /> 1 -S 3 C ' It Z '.y = I k <br /> 3V <br /> V <br /> — 2 I GOOD CONDITION__.. tolPRI kJ <br /> �-�- 2L JI DECHLORINATED IN LAB_'_PRESE R D Ff LAB_— <br /> 8*8 lea al IA67-1 <br /> %4-b- 3.S 0',Lp PRFSEWATION <br /> - <br /> Collected by: AL'15SA kk 20 a` Collector's Signature: <br /> Relinquished by: I l Date/Time Received by: Date/Time <br /> Relinquished by: Date/Time r' zs °P I'12o Received by: Da(e/Time <br /> Method of Shipment: Sample Condition on Rcpt: <br />