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i - - Record <br /> Project Name <br /> No. <br /> Sampler: (si nat r ) of ��yJ�y`J; 1 ��U <br /> / con- c 4 , <br /> O ` i tainers <br /> Location Date Time Location Description ` <br /> I.D. • Type*-position '`` Remarks <br /> tri :1_Z 1 7 <br /> AsA <br /> • • <br /> eI hj <br /> 8 7- <br /> • • <br /> s • f <br /> Relinquished by: (sig tura) pate/Time Received by: (signature) Relinquished by: (signature) Date/Time Received by: (signature) <br /> / X93 ,-, a / '� J. (.-� <br /> ,rye I y <br /> + J <br /> o 4 > <br /> Relinquished by: (signature) Date/Time R cp)V by: (signature) elf IS ed by: (signature-)- Date/Time Received by: (signature) <br /> 1 <br /> Relinquished by: (signature) Date/Time Received for Laboratory Datefrime Remarks <br /> 11 A <br /> Data relinquished from Lab Date/Time Data received In EQVG by: Data relinquished by: Date/Time Data received by: (signature) <br /> (signature) / y (signature) (signature) <br /> Data archived by: (signature) Date/Time Distribution of copies: <br /> Pink—Sample Collector <br /> Canary—Analytical Laboratory <br /> Form GAP-&I White—Return to EQVG <br /> Rev.0 <br /> 18,Ise? <br />