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_ <br /> of-Custody Record <br /> Project Name h <br /> G L No. <br /> S p :(signator of `X <br /> _ Con- c+° <br /> v- tainers <br /> Locati n <br /> Date Time Location Description Remarks <br /> I.D. •Type*-Position <br /> L F> I c <br /> �5cc. S Tv <br /> . " P CL&®®U <br /> Z-,t F L c-pj L <br /> . . <br /> . . <br /> X1lnqUu <br /> lsh y: sig ) Date/Time Receiv : (signature) Relinquished by; (signature) Date/Time Received by: (signature) <br /> �/ L �t <br /> hed by: (signature) Date/Time Rece y: (signature) Rel! q*shed by: (signature) D te/Tlme Received by: (signature) <br /> Relinquished by: (signature) Date/Time Received for Laboratory Datefrime Remarks <br /> by; (signature) <br /> sW <br /> Data relinquished from Lab Date/Time Data recei ed In EQVG by: Wai�rellnqulshed by: Date/rime Data received by: (signature) <br /> by: (signature) (signature) (signature) <br /> Data archived by: (signature) Date/Time Distribution of copies: *See reverse for codes. <br /> Pink—sample Collector <br /> Canary—Analytical Laboratory <br /> White—Return to E®VG <br /> FOM aP4a-1 <br /> hv.0 <br /> 18,1987 <br />