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CHAIN N OFICSTODY Page 1 of 1 <br /> ClayLab �T c�� 1 <br /> cxout' skhv �cts <br /> TAT <br /> Report results to <br /> Name ! CL K(,14 J Project Information <br /> Company CI yton Group Services Project No ZKo —aZ Z� <br /> Mailing Address 6920 Koll Center Parkway, Ste 216 Name 71%-11- Cif<Y- ca •�1011V1-I__ <br /> City, State, Zip Pleasanton, California 94566 Location 771,( /V.MV Dry C <br /> Telephone No (925)426-2600 <br /> Fax No (925)426-0106 Anal ses Requested <br /> khc JAAJ&CJC, �n'r f COM <br /> Special instructions and/or specific regulatory requirements kcJ 4 <br /> 1Q n 52 <br /> l o a f� ro <br /> z <br /> Date Time Matrix/ No of 0. � Sample Condition/Comments <br /> Sample Identification Sampled Sampled Media Conts kj 1Q0 <br /> o <br /> W l l 2! 0 3 5 r XJ Yl V Ice/HCI <br /> Z ! 2► 3 1 Ice/HCI <br /> 44 <br /> {n) r 2► o Ice/HCl <br /> Collected by Collector's Signature Date/Time t zt •3 45 <br /> Relinquished by Date/Time r 83 16 Received by Date/Time _ <br /> Relinquished by DatelTrme Received by r te* DatelTime 0IN-1/05 <br /> Method of Shipment Sample Condition on Rcpt <br />