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^ CHAIN OF CUSTODY RECORD BCA Log Number f <br /> Client name Project or PON Analyses required <br /> Address Phone N Lp <br /> / -�p 1� t� .E.S.T. <br /> City,§i ale.Zip Report attention o <br /> 7 ' C� • <br /> CA 3 ate <br /> Sam led e <br /> Lab Number <br /> Sample Date Time See key of ap�'� <br /> number sampled sampled below Sample description containers 2 y`� Remarks <br /> cot 1 <br /> L-D, W/,kP) oza "d <br /> -rcLP Ccrnpn-5 ME <br /> c -- r ?4 <br /> Signature Print Name Company Dale Time <br /> Relinquished ~ Z�-Iaczcalipr � <br /> FReceived by <br /> R©1inquished by <br /> WRocomod <br /> by <br /> Laboratory <br /> B C ANALYTICAL Note:Samples are discarded 30 days after results are reported unless other arrangements are made. 'KEY: WW—Wastowalor SU—Surlace Water SO—Soil <br /> Hazardous samples will be returned to client or disposed of at client's expense. SL—Sludge PE--Petroleum OT--Olher <br /> ❑ 1255 Powell Street,Emeryville,CA 94608 (510)428.2300 <br /> ❑ 801 Western Avenue.Glendale,CA 91201 (818)247.5737 <br /> Disposal arrangements: NA—Nvnaqueous GW--Groundwater AO—Aqueor <br /> ❑ <br /> 1200 Ger " y Way,Anaheim,CA X92805 (714)9780113 } ' <br /> ✓ i....rr �, l lt�r i� L—j <br /> a <br />