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M r v M = M 1=1 �� tttttttttl■ ttftttttfttl• <br /> CASTIP ANALYTICAL LABORATORY , , CHAIN aF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 938/909, Atwater, CA 95301 Certificate No �79 j <br /> Mailing Address 2333 Shuttle Dave, Atwater, CA 95301 PAGE� OF_L_ <br /> Phone (209) 384-2930 - Fax (209) 384-1507 <br /> Customer Adds nCed [�art u l r17,1 nW fAj J� REQUESTED ANALYSES Method of Shipment <br /> Address $a 7 W. !jhAw Q 2 �3 � 0 CA UVGY h t h k <br /> City/State/ZIP _Cbp� [',,oy '—` o Z Nates <br /> Phone / FAX -291"141-"- Z (07` !1 9 w N © z <br /> L r o <br /> Prod # AGI {?G Clil WGi � <br /> a � x <br /> Report Attention C� w -9 a ° <br /> Sampler Signature IL g 76 m ~ ~ Uj <br /> Printed + ` <br /> z <br /> N <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTIONILOCATION OBSE <br /> + 2-7 ;I,741 1 ou 64269 <br /> Z r <br /> 64270 �l <br /> / s <br /> 64279 <br /> s/ t3os <br /> + 3� 64272 , <br /> -r <br /> 64273 ' <br /> —71 OD 64274 ' <br /> zzo 64275 ' <br /> 64276 ' <br /> 64277 <br /> 64278 <br /> Signature Printed Name nate Time Company Name i Total RU-- _ f I64279 <br /> Relinquished by JjeA-yWj4 Jj`Ca k, Note All spe <br /> Received by �r�� �f fi (y� �2� �ZQ turn Mmes)must be cleared through <br /> authb razed laboratory personnel <br /> Relinquished by <br /> Received by <br /> Relinquished by RESULTS DUE <br /> Received by VERBAL WRITTEN <br />