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By signing this form, I understand that the equipment listed above will be returned only to Calscience for analysis, <br /> and will be in the same condition as received. It is also understood that the rental period is two weeks from the date <br /> signed above, and must be returned within that two week period or additional rental fees will be incurred, as <br /> described in our Standard Fee Schedule. If a minor(one or two day)extension in the rental period is needed, you <br /> must contact your Calscience project nager fore t rental period has ended to receive permission. <br /> Relinquished By. Affiliation: CalScience Environmental Labs. <br /> Received By: Date/Time: _ Hours: <br /> Printed Name: Affiliation: <br /> W" 7440 Lincoln Way, Garden Grove, CA 92841-1427 TEL: (714)895-5494 FAX: (714)894-7501 <br />