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SPARGEPIffifCHNOLOGY, INC. CHAIN OF CUSTODY RECORD • f <br /> AnalyticalLaboratory oratory Phone (916}362 8947 <br /> -1050 Fite Circle 0112 Sacramento CA 95827 FAX (916)362-0947 <br /> Company APEX ENVIROTECH, IVC Phone (916 ) 535-0200 <br /> Project Manager ,JEFFREY ROTHGERY FAx (916) 535-0207 STAL Invoice Number <br /> Report Address Billing Name&Address <br /> 7844 Madison Avenue , Ste 106 <br /> Fair Oaks , CA 95528 ANALYSIS REQUEST <br /> Project �t Name n Project/Job N REMARKS WET (STLC► <br /> I�y}co-t-2!"eft C'I.v M � 00 'pi- ��� 04� Z Dtc�I I�R��9�icwt,� <br /> Project Location i y$0C3 C-'S j"'yb dtJe"TN PWI PO N TCLP <br /> Preservative TCLP Total <br /> Sampling Container used Matrix TAT <br /> � N <br /> o w <br /> oV o <br /> U) C <br /> e .� <br /> In [ N N <br /> O <br /> OO N z v <br /> bt1 rO m a m v a w <br /> '- N o_e— N V N ... a V <br /> pq r9 O 0 u 01 in <br /> O a] N �% a0 N in 0. U 7 <br /> N N O N c U 111 ry it <br /> O O O n N N w C n 4 <br /> In N �p In i1n in 4 0 A U C <br /> r i Z O O O O d O E c vi A <br /> U W m a N w w N N `� v o m o c <br /> a o N rs N O 00 m w w +a o <br /> D O b 0. N m w 7 N 4 <br /> .1 N E Z ` '� t m 1O0 4D to m Ip U d C hin N <br /> E m �' z c x — x w w ¢ ¢ ¢ ¢ Q ¢ m c m V y v_ <br /> U o o H i- a a a a d a o a V ¢ Q a O <br /> SAMPLE 1D Date Time $ m` o z z o 3 ,n a o m m L. o cc 0 U -J w m s <br /> ?-l9-g7 I yo X dp' <br /> r I <br /> Relinqu d y Ree d by Relinquished by Received by <br /> ? 2-zo- 7 '14:K9- Date Time Data <br /> IT;m(, rj:�� Date 7 Time <br /> l i <br /> I <br />