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CHAIN OF CUSTODY APPS, Inc. <br /> 7o� <br /> 010986 REC 4203 W. Swift Avenue, Fresno, CA 93722 <br /> Ctockton 190855-0006 Phone: (209)275-2175 <br /> Fax: 209 2754422 <br /> Project Name/Number Sampler(Print) Analysis Requested/Method Number Date Shipped: <br /> A 1?L li" 10 L Carrier: <br /> Purchase Order Number Sampler(Signature) — <br /> 2-G, �LNB .// 'J C N G Waybill No.: <br /> Comments: <br /> oat. run. Numbe,of U N .•.j <br /> Sample Identification conected Cclleaed Mat* conainem <br /> k^_L- 3A- GWibh �z1` 1t0a i 3 ��.► OA <br /> A- <br /> "—L,- - ��a I i�oo S z t Gtass 1 Pc, ,n� tat. <br /> T V,-ZV I N�C vas <br /> Shuttle Temperature: Turnaround Requested:� Sample Disposal: <br /> 2-ESu�.'r P <br /> Standard(2-3 week) ❑ One week ❑ 2448 hour 113 Return to client ❑ Disposal by lab(3o-day retention) <br /> Relinquish% J sampler. Date Time Received by: Relinquishedby: Date Time Received by. <br /> ��.. /� z ia � ,mac . <br /> Relinquished by: Date Time Received by: Relinquished by: / ate Time Received y: <br /> lab b <br /> ej- r'y� IUUG <br /> Report to: Blit to: _ <br /> C AtM 0 i?�2 �u � Mr-� c,.Z�, SAw\ S Px-rt <br /> I Cr, i`'�'a�LE AVG -=-;Ll VrC 3C� ;711-11 � 1 <br /> �X'NAL,n►"T CakM4-t CA- q 45`'1 <br /> P .at0C133,V-160 FAQ: <br /> White: Return to client with report Yellow: Laboratory Copy Pink: Sampler <br /> c.o.c. N° 2069 <br />