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CHAIN OF CUSTODY RECORD BCA Log Number <br /> Clie t n e. Project r P # Analyses required <br /> Addresse,50 <br /> Ph Se 'Q <br /> 2. Qy J\0a <br /> City,State,Zip Cc, r Repo attrition <br /> Sampled oy <br /> Lab TYPe• G Number ao��r <br /> Sample Date Time See key <br /> number sampled sampled below Sample description containers `1 rO�coQ Remarks <br /> q SSD <br /> IqIS1 oC= - z - , 5 <br /> 00 - .-Z 1 <br /> u -t2 flC CQ flesdaf <br /> /2adn <br /> 6--1 tz Z <br /> o z <br /> w.Pell <br /> Signature Print Name Company Date Time <br /> c <br /> Relinquished by JI_ _s S M <br /> Received by ✓"��� ��� <br /> Relinquished by <br /> Received by <br /> Relinquished by �s <br /> Received by Laboratory ,N4( J ona G rS L-G KC el cxe w l t /92 16: 30 <br /> B C ANALYTICAL Note: Samples are discarded 30 days after results are reported unless other arrangements are made. 'KEY: WW—Wastewater SU—Surface Water SO—Soil <br /> 'J 1255 Powell Street,Emeryville,CA 94698 (510)428-2300 Hazardous samples will be returned to client or disposed of at client's expense. SL—Sludge PE—Petroleum OT---Other <br /> NA—Nonaqueous GW—Groundwater AQ—Aqueous <br /> 7 80i We, <br /> jern Avenue,Glendale,CA 91201 (816)247.5737 Disposal arrangements: <br /> C7 1200 Gene Autry Way,Anaheim,CA 92805 (714)978-0113 <br />