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� � � �■■� � � � s � � lis � � � .� � � � <br /> KIFF h -'fT1Lht CHAIN CUSTODY <br /> 1-10 O{►We, Dv,I Ste D ! .r(O <br /> IL <br /> Remo 6d&A1eta6- <br /> Dov 15, G 6 Pr ect Name Protect No <br /> r5 <br /> PO No Sampled By <br /> -�C� t R ►�l Q �a <br /> cr) �M <br /> Company p a w a "'. E.tV I'y�0 h hl?k t nn fo S t 4 iit a e— r) Analysis O� <br /> Address 11GI0 f;K rove. y wut S 41 e "L100 m 4% <br /> RAKG1,c Nlkr�� twi, .Cly 95093 <br /> Phone No . <br /> (416) 3 5 4- 32 <br /> 5© Fax No r <br /> l J g 1 0) 3 5 T z 7 { �c •�• <br /> Bdhng Address Sg V, L Expected Due Date D A m 4 <br /> Cd Cd a v <br /> O <br /> Requested Turnaround X 5 Day(Normal) 48 Hr 24 Hr Other w <br /> o cL Z. <br /> Sample Date/Tlme Sample ID N E L Identification M a L� Remarks <br /> 0150,6 W10 M\N - 1 5 'N I A 1K x K <br /> 1115 19% 1410 KW -3 SIWAIVIX X - oz- <br /> W A X X -03 <br /> CustodySeal intact? Y N None Tema Box N1 DW Drinking Water so soil Box#2 A HCI a Ice only Box#3 H High <br /> p WW Waste Water SD Solid B HNO F Other M Medium <br /> RW RCFlA Water AD Aqueous C H 5d G Not Preserved L Low <br /> Condition when received good oL oil A Air D NaOH <br /> SG Sludge U Unknown <br /> Relinquished by Received b <br /> (Print) (Signature) Date/Time y <br /> (Print) (Signature) Date/Time <br /> IlTo sreti <br /> 2 <br /> 3 i <br /> 4 / n� ' <br /> luAb I_.Er-J <br /> This report Is applicable only to the sample received by the laboratory Tha iiabdiry of the laboratory is limited to the amount paid for this report This report is for the exclusive use of the client to whom it is addressed and upon the condition that the client assumes all liability for the further <br /> distribution of the report or Its contents <br />