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CASTLE ANALYTICAL LABORATORY -G� • [04CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 Certificate No 2079 <br /> Mailing Address 2333 Shuttle Drive, Atwater, CA 95301 PAGEOF <br /> Phone (209) 384-2930 - Fax (209) 384-1507 <br /> Customer ](' REQUESTED ANALYSES <br /> of Shipment <br /> Address 37 51,4uj �'Mj g X s _ 8fi149 <br /> City/State/ZIP -4 k S �, � o U3 Q P <br /> ~ to zPhone I FAX <br /> Prod # 1 P D # �1< 't" 86150 <br /> LU <br /> Q in J! a m U <br /> l a 0 <br /> Report Attention '� &A a 'Cl F- IM <br /> a a <br /> Sampler Signature 8fig <br /> 86151 <br /> Panted <br /> z <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION � 86152 <br /> $ �- 86160 t - 86153 <br /> AMA I u LAO <br /> 86181 86154 <br /> s � <br /> Q- 86162 s 86155 <br /> 6 3 <br /> ' <br /> 86163 k 86156 <br /> 1 � o <br /> 4 86157 <br /> W 3 3 v-"'86158 <br /> AM I - - 86159 <br /> U it Total number of containers submitted to <br /> Signature Printed Name Date Time Company Name the laboratory <br /> Relinquished b (j •, Note All special requests(e g quick <br /> turn times)must be cleared through <br /> Received by authorized laboratory personnel <br /> Relinquished by <br /> [Received <br /> eceived by <br /> RESULTS DUE <br /> elinquished by _ <br /> by VERBAL WRITTEN <br />