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CHAIN-OF-CUSTODY RECORD •` <br /> 10500 UNIVERSITY CENTER DRIVE AND ANALYSIS REQUEST 23755 <br /> ,GTOL TAMPA, FL 33812 <br /> E N V I RON MENTAL (813) 979-9092 <br /> LABORATORIES INC �y <br /> Company Name Phone# �,, '7 ZS`C�7 <br /> 13 13 <br /> f" �, FAX# [34,4xica- 7- 0e E]Company dress Site Location Z l_� 4' — '/ <br /> CD <br /> ❑ U o ❑ <br /> x�Z r-r.f if r ! r s ❑ C:) r N O_C13 W C3Ln Y i4 <br /> Project Manager —t ) Client Project D �(y#�)02�7{}3r27Q 6 Lu <br /> ❑ p _ ❑ <br /> L^ot�b r. G-n. •tax m 6 0 ❑ C7 CO z O� 0 n <br /> r k <br /> p = NAME <br /> I attest that the proper field sampling r Sampler Name (Pant) °y o ❑ ° o 0 �o 5 U° o p <br /> procedures were used during the collection v� 0 °to cD � N ❑O ❑ <br /> of these sampies ❑ rL ,� N a a a ¢ <br /> Method N d �, g ❑ o m ❑ o <br /> ca o <br /> u� m ¢ <br /> 1. <br /> atrix Preserved Sampling 0 w ° w ¢ ¢ p ❑ o ' N ❑ <br /> Field °' ❑ m � -j 2 C4 Q <br /> ° ❑ <br /> GTE b w ❑ z $ e _❑ a ❑ d ❑ <br /> Sample Lab # C w pp (per p N m o M <br /> rb C7 a [L T u7 cO O N N X TL LV in <br /> ID (Lab use only) 0 o CC o" o - - r W w z m a ¢ ¢ ¢ ¢ ¢ ¢ o ¢ ' ` } <br /> w ¢ t- U z W g �a ¢ t— F- } ?, a o a a o o a o. a o� v n ¢ w a' <br /> y ¢ rp a d a 2 2 L oy o F m m z 2 3 w w w w w w w w \w w U 0 U 1 <br /> - N <br /> ILA <br /> k• _ <br /> n <br /> Y <br /> TAT Special Handling SPECIAL.DETECTION LIMITS REMARKS <br /> Prlorlty(24 hr) ❑Y GTEL Contact <br /> r, <br /> Expedited{48 hr) ElQuotelContract# ra C � Y 12„4— <br /> 7 Business Days ❑ Confirmation# <br /> SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location , <br /> Other PO# <br /> Business Das ❑ 12)ax f <br /> OA 1 QC LEVEL <br /> BLUE❑ CLP❑ OTHER FAX❑ Work Order# t E -r� <br /> Reling4ished b ,Sampl f , Date Time Received by <br /> llh <br /> 1 r 3p <br /> ReRnqul. ed by D to Time Received by t <br /> CUSTODY <br /> 'RECORD Ret quished by D to Time Received by Laboratory <br /> O Waybill# <br /> RAv'7191 ,1 <br />