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SPARGE. . TECHNOLOGY, INC. CHAIN OF CUSTODY RECORD <br /> Analytical Laboratory Phone:(916)362-8947 C.O.C. NO. 26749 <br /> 3050 Fite Circle,#112 Sacramento,CA 95827 FAX: 916 362-0947 Page_� ofSTAL Invoice Number: <br /> Company: 1 T � Phone: �/ (O qJ 9� "�3wD ANALYSIS REQUEST <br /> Project Manager: D-AJ —,�, FAX: (9i6 /�$"-33`} REMARKS: 1 ' �1 Sampler's Name: <br /> Report Address: Billing Name&Address: N O `�P{ t —F P <br /> C,+ 9 S-Y3 All None "Some <br /> Project Name: Project/Job#: OK OK WET(STLC <br /> O) 0( Cooler Temp. <br /> Project Location: Po.#: Sample Condition TCLP <br /> H <br /> Preservative TCLP Total <br /> Sampiing Container Used Matrix _ -7 T7 I I I J TAT <br /> w q r <br /> $ 00 <br /> t2 LL <br /> H O _ C 4 Z N <br /> N L <br /> cli !9 <br /> gCM <br /> 0 0_ <br /> z v w <br /> C\1 E a a y n <br /> 0a- _0 0 0 0 0 0 2 06co to <br /> a 2: $ $ m a0o ago C\1 <br /> U Z <br /> a a °—J E _� <br /> NO. SAMPLE ID Date Tlme m �' i° ►- �" a a a ii a aa- ii o `o 2 v h � � � Q ro 5 o <br /> Q1 f0 W W W W w W 2 0 cc J U) <br /> Ix <br /> 2 - 11 KI� ' <br /> - a rr4o X <br />� 4 -14 rl x <br /> 5 -� 115-0 <br /> 6 -N - o,r <br /> 3 r as <br /> — I", 1 s <br /> s - o. t <br /> 9 — `} 1 o <br /> 10 Lo !3'FS <br /> R d by: Rec iv Relin uished b : x <br /> 4 Y Received by: <br /> Date: - D t� Time: I <br /> �� Date: a Time: 7 ' Date: Time: Date: <br /> PLEASE READ REVERSE SIDE FOR TERMS AND CONDITInNe �. Time: <br />