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z California Water Labs, Inc. <br /> ' P.O.BOX 4249 <br /> 1430 CARPENTER LANE—SUITE G <br /> MODESTO,CA 95352 <br /> PHONE(209)527-4050 <br /> CHAIN OF CUSTODY RECORD <br /> PROJECT NAME: <br /> S PLERS-(signature) <br /> Number T <br /> - fiwlt of REMARKS - <br /> StationCon- .. <br /> Number Date Time U Station Location tainersCM <br /> X K �-(� 74970 <br /> 64s <br /> 7 <br /> r f f< <br /> 02 <br /> 1 <br /> Re `nfquished by(stpature): DateV / Time Rece ed b (signature): Relinquished by(signature): Date / Time Received by (signature): <br /> Company orAgency% Company or Agency: Company or Agency: <br /> any or Agency: <br /> v v <br /> Relinquished by(signature): Date / Time Received by (signature): Relinquished by: Date / Time Received by (signature): <br /> Company or Agency: - Company or Agency: Company or Agency: Company or Agency: <br /> 1 nq ihed by(sig'nature): Date / Time Received for Laboratory by: Date / Time Remarks/Shipping Information <br /> (signature) <br /> • Com y r A ency:� ` I� \� ` � •C �� (� �v• �?� (,il/��(/�-�"�-�� � Irl/�/ <br />