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1 <br /> K KAPREALIAN ENGINEERING, INC. <br /> CHAIN OF CUSTODY <br /> ISAMPLEg I SITE NAME d ADDRESS ! ANALYSES REQUESTED I TURN AROUND TIME ! <br /> w <br /> IWItNESSING AGENCY I <br /> I I 7 303 Pit c.Y/,/,c /-�vc S Tx�'7� I � I <br /> I �I I I I I I <br /> INO <br /> I SAMPLE I I I I I I I OF I SAMPLING I I �I VI I I I R E K A R K S <br /> I ID NO I DATE I TIME I SOIL IWATERIGRABICOMPICONT I LOCATION I �I rI j0 I opl I I I I <br /> PPS <br /> V l ✓l��I I I I I I I Ii 1 �S <br /> ! � ! � a zl ! 1 Iv1 IzvNI ! vl �l ✓ ice ( l I � � I <br /> I' }i I }�41 I f ! VoI 1 ✓I ✓ I v C ✓ I } ; I <br /> I I I I I I l f I ! I I I I I l I I <br /> C I k 1 ! I I I ! ! f I I I I ! I I <br /> 1 I I ! I 1 1 1 I I I f I I I I I I <br /> (Relinquished by ( igna ure) I Date/Time I Received (S gnatur ) I the following MUST BE completed by the laboratory accepting samples I <br /> I for analysis- I <br /> T Have all samples received for analysis been stored in ice? <br /> I IRe(angrished by (Signature) I Date/Time I Received by (Signature) I ! <br /> Z Will samples remain efrtgerated until analyied7 I <br /> I � 1 <br /> (Relinquished by (Signature) I pate/Time I Received by. (Signature) 13 Did any swptes received for analysis have head space? I <br /> }-----• i 4 Were samples tin ropriate containers and properly packaged? I <br /> IReii"fished by (Signature) I Date/Time I Received by (Signature) I I <br /> I ! I Signature Title Dat I <br />