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f� 4xatichem'- <br />E!Lvilronfftental Labs <br />6W Giuseppe Court, Suite 3 <br />RosMle, CA 95678 <br />Ph: 916-773-3664 Fx: 916-773-4784 <br />CHAIN -OF -CUSTODY RECORD AND ANALYSIS REQUIZST <br />Project Manager- <br />Phone t <br />Electronic Data Deliverables Request: <br />&V�dj <br />(01 Iz. I J ly I - 4 <br />Global l.D.#. <br />Ernad Address: <br />CornpanylAddress: <br />— �p 2-1 <br />Fax #: — <br />COC #: <br />. J J*L&C* �M owco) a 4 ccv <br />r1laz <br />ha <br />49 (0 <br />Location <br />I.D.#: <br />e-eL - qdV <br />`®a r- S r,, 34C yaK <br />1 e.4 7211 <br />ANALYSIS <br />REQUEST <br />Pae of <br />Project Number/P.59: <br />Project Nape: <br />"- i' <br />ZU31 <br />Tolal -IJ <br />Project Location: <br />ler ighature: <br />t <br />J <br />CA <br />Sampling <br />—IMethod <br />Container atria <br />rix <br />C <br />Go <br />E X. z <br />Sample <br />Preserved <br />a CD <br />W co V9 <br />z <br />.9 <br />ID Date Time <br />ut <br />v <br />Cr <br />0 <br />a <br />9) S fz r-6 <br />n o B"=L <br />0 CL <br />EU -J <br />< LU <br />0 <br />0 <br />0 z 0 tr <br />0 <br />w <br />L'L OF C� CL <br />0 <br />CL IL < <br />- tA.8 IJSE <br />x M z <br />CL ,ua CA <br />L- LM <br />I X01 <br />�q4 <br />k(A <br />S^ 62V <br />b9W <br />wa <br />,amo <br />+ <br />y <br />Relinquished by: <br />Date <br />Time Received by: <br />Remarks/Condition of Sample: <br />I"Inquished'by: <br />/V/'1d3JdJ <br />JJ 1g, C <br />H 44.0 lol AtAW <br />Date <br />Time ceived by: <br />&4,b7 re4Lttj -fyo*,% amg4s.s ale- knowl,"' <br />. I <br />tW,( c r L(-- (Air u*A 11114f r" t, I <br />(I a4,x 144 ow A <br />Relinquished by: <br />Date <br />Time <br />Received by Laboratory: <br />gilt To: <br />4'a <br />