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SIERRA LABORATORIES CHAIN OF CUSTODY RECORD <br /> TEL 714-348,9389 dale. ���°19� Pageur <br /> FAX 7I4.34$•9115 46� <br /> 26052 Ment Circle-Suite 105 •Laguna Hills,CA•92653 Lah Project Na &—/0 ` <br /> Client ?f 1 , Client Proj Number/Proj Name Analyses Requested <br /> Cllenl Address 60,94 Lt S♦�f",S�CJ`� �`� � <br /> Turn Around Time Requested Immedlste Attenlloa <br /> Rush 11-41 hour <br /> Client Tel Na <br /> ❑Rush 72-94 hour <br /> Client Fax No Na mal Q 7 <br /> Cllenl Pro) Mgr G ❑Mobile <br /> � e <br /> Sierra Container No.or 6 S ? <br /> Client Sample No Sa le No Dalef lirw Matrix Preservatives Type Containers R 6` 6 Cumnxnts <br /> N1W- 2.P 6K to .v-6-ss- �l i�IL <br /> 3 4C <br /> mw-3Q 96(k 1X <br /> MW— P&12- <br /> M\// 8613 k <br /> riw--i P 8 t-P f Sao's X X <br /> L4? 961s i X ix <br /> vt 6lwn �vo�, <br /> a <br /> Sampler Signature Shipped vin Total Number of Containers Sample Disposal <br /> i prrinledle me (cartier/Waybill Nel Submitted to Laboratory Rernenle Client <br /> a• `0�4 The dethan <br /> ery olwmplm d lhw <br /> esipalureen this chain ofewtodr fwm consthos <br /> Reti ulshed fl Date Received D Date �Y- tulhmlydao sopertorm the ana7ar speclned above fader SIERRA*$Torras end Lab Disposal <br /> �p � � p �As ConAtllelr,¢airs otherwise agreed upon Is wrung between SIERRA and CLIENT <br /> Con+ an Tlmr Can Timr/v <br /> ❑ Archive_mu <br /> "Ingulebed By Dow Reeeleed lir Date, Total Number of Containers Otnee <br /> company Time Company Time 29 Received by Laboratory <br /> 0 FOR LABORATORY 135E ONLY-Sample Remipl Condiliohse <br /> Relinquished by Date Recelred By pair L�JhRkd L) Appropriate saenpleCoeginer <br /> Can an Time co-PAP-7 co—PAP-7Tin. I--r � <br /> Special Instructions Approprl+le Ataetvnlgeew <br /> $ampkSedg Wbiber, V0,q A If�n <br /> Properly Lobele0 SrlmPle Location <br /> _]OM � U1STa1� L t=cramp Sam les, r= slory vin Feradaele opr_ <br /> r I <br />