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DelillennolKerdooll <br /> Chain of Custody <br /> "FecyrlinrJ For <br /> 2000 North Alumedo Street•Compton,Cil 90222 l Z <br /> (310).537-710() FCLr:(;310)639-1''54 Date Page I of--t <br /> Gi-J�PlSFLLF Cerrifits[e#2037 <br /> Client: + Contact: Tel: ;tblFa,.- <br /> Address: <br /> a,:Address: 2, City: S��c�zf-y� State: C Zip Code: �© <br /> �S <br /> Project Name: p ( ) Signature: <br /> S`am Ier s <br /> Project Manager: Approved By: <br /> Dice Date Regular [:) Rush Days Comments: <br /> Lab Date Time No. of <br /> Sample Description ID Collected Matrix Containers Analysis Requested <br /> C- VA k Gr}� c�L Sr2�° <br /> r <br /> � r � <br /> Sample Conditions: Seal ❑ Intact Broken ❑ None; Temperature ❑ Cold ❑ Room; Other <br /> Relinquished by (Signature) Received by (signature) Date/Time <br /> R(dinquished by (Signature) Received by (Signature) Date/Time -1-2- (1-/Z - //j3C <br /> Relinquished by (Signature) ��_ Received by (Signature) Date/Time <br /> SPE a L INSTR UCTIO <br />