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CHAIN OF CUSTODY RECORD BC LOG NO. <br /> Client name Job number Analyses required <br /> 4<� 1 333 8 - 0 2. z <br /> Prosect name a �� <br /> ,S l'te -F-,7✓e 5 fiP' <br /> 4P-b0 S lam.I-i�v� C�U 2�0 -72J C.c I'l-f-ec ci, <br /> Project manager Sampler(s) ° <br /> L_a Ph/,//i ,s (-\JA <br /> Type doh rac <br /> Sample Date Time Composite Number <br /> number sampled sampled Sample description of RQ Q ti° Remarks <br /> Gib containers <br /> IXXIXX- <br /> te'( <br /> I <br /> i <br /> 72- -3 /'S '' 5" & <br /> i SGf crcc✓r t e�t CA <br /> /2- <br /> 3 <br /> I <br /> Signature Company Date Time <br /> Relinquished by: � <br /> _/ t. c- cGr � <br /> Received b <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by <br /> BROWN AND CALDWELL Analytical Laboratories Note: Samples are discarded 30 days after results are reported <br /> ❑ 1255 Powell Street, Emeryville, CA 94608 (415) 428.2300 unless other arrangements are made. <br /> ❑ 373 South Fair Oaks Avenue, Pasadena, CA 91105 (213) 6814655 Hazardous samples will be returned to client or disposed <br /> of at client expense. <br />