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q1 <br /> ,)7M 2�f2 Page —of y <br /> f <br /> Environmental Laboratory pt 8880 Interchange Drive Analysis Request and Chain of Custody Record <br /> Houston, Texas 77054 <br /> 713/660-0901 <br /> Project No Client/Project Name Project Location <br /> Field Date a Sample Sample <br /> Sample No1 and m a Container Type(Liquid Preser- ANALYSIS REQUESTED LABORATORY <br /> Identification Time 6 U (Size/Mat 1) Sludge Etc) native REMARKS <br /> mple ignature) Relinquished by A Date 31 l5 Received by Date Intact <br /> (Signature} (Signature) <br /> r4—(-u `/z <br /> Time �g�� Time <br /> Relinquished by Date Received by Date intact <br /> k"ec-11-1vilf puiee� (Signature) (Signature) <br /> Affiliation Time lime <br /> Relinquished by Dale Received by Date Intac r, <br /> (Signature) (Signature) / i <br /> Time Time _. <br /> SAMPLER REMARKSRec r o a Laboratory No <br /> (Sr Time <br /> Seal a Data Results to <br /> s <br />