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CHAIN OF CUSTODY RECORD <br /> w <br /> PROJECT NO. SITE NAME&ADDRESS <br /> S E ST — w p oD B2 r,p� E- <br /> ANALYSES REQUESTED �1) <br /> f` y� <br /> WITNESSING AGENCY/INSPECTOR NAME/DATE <br /> m w -0m <br /> W REMARKS <br /> m <br /> ID NO. DATE TIME ¢ SAMPLING LOCATION � _ z m a <br /> O o m <br /> F- 2 m T <br /> CTS--INF jooZqz1-loo ix TROMNEWT srSrRV) INPLUL=ur 80(� 020 <br /> x <br /> YS_ EFF I DW i ("too x SVe,1eM Fftu ENT oc <br /> B no's So2. o <br /> ='f <br /> :fr <br /> r <br /> r$. <br /> r <br /> r <br /> Y c <br /> i5 <br /> " (1) See attached"Table 2" <br /> for specific analysis method. <br /> Relinquished by: (Signature) DatelTima Received by: (Signafuro) The following MUST BE completed by the laboratory accepting samples <br /> for analysis: <br /> 1. Have all samples received for analysis been stored in ice? <br /> Relinquished by: (Signature) Date/Timo Received by: (Signature) <br /> 2. Will samples remain refrigerated until analyzed? <br /> Relinquished by: (Signature) Date/Time Received by: (Signature) 3. Did any samples received for analysis have head space? <br /> 4. Were samples In appropriate containers and properly packaged? <br /> Relinquished by: (Signature) DateMme Recd for Labor a ry by: (Signature) <br /> yQ/ /?z- Signature .Title Date <br /> CtECON <br /> CAi.IFORNIA ENVIR(WALHIAL ENG'INUR'.. Ar COMPACTORSLL <br /> �ltr <br /> '1•l I'AI IIf IM1 ,'.1' I`T!' I-I: I I Ir . <br />