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Ch irrdf �, 4 Qyuanterra <br /> Custody Record E��smental _ <br /> ouru749 '{L <br /> Client Protect Manager Date Chain Of Custody Nume <br /> II- 4— 13811 , <br /> Address Telephone Number(Area Code)/FAK Number Lab Number <br /> 1134 34th STRUT- - 5 0) 6 f( -q p Mae Page of r <br /> City Stare Zip Code Site Contact, Analysis <br /> Project Name Cam`erlWaybill Number <br /> SAXPLIS -10100- o1 -0L 540t.64k a <br /> 06.CorttracVPun;hase Orrier/Ouota No <br /> IT ICUSUP Tot Au RA AUSTIN <br /> Total Containers t <br /> Sample l D No and Descnptlon Date Time Sample Type Volume Type No Preservative Condition on Receipt f <br /> O w2x Hzo ` r -9� <br /> ee <br /> 6 r- <br /> Special Instructions 1 <br /> , <br /> , <br /> , <br /> Possible Hazaad Identification Sample Disposal 5 <br /> Non Hazard ❑Flammable ❑Skin Irritant 11Poison B [3 Unknown ❑Retum To Client Disposal By Lab ❑Archive For ( Mor,the , <br /> Tum Around Time Required QCC Levet Project Specific(Specify) " <br /> i <br /> Normal ❑Rush Ell ❑It ❑III <br /> I Relinquished By Date Time I Received By Date Time <br /> C. <br /> 2 Relinquished By Date Time Tj,RecejVPd By Date Trme <br /> 3 Relinquished By Date Time A Received By Date Time <br /> t <br /> 1 <br /> Comments �f ` <br /> 1 J <br /> DISTRIBUTION WHITE Stays with Sample CANARY Returned to Client with Report,PINK Field Copy <br />