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r r� r r■r +� � � rr ar■4 �r �.. .s •. <br /> Chain of Cufody Record Date z�Z.9 z-* <br /> D Q 148 S Vtnewood St , Escondido CA 92029• ph 760 735 3208 •fax 760 735 2469 HPL Project#A FO D,2010-2 `3-- <br /> ® 432 N Cedros Ave , Solana Beach, CA 92075• ph 858 793 0401 •fax 858 793 0404 <br /> LABS Q 2373 208th Street Unit F-1,Torrance, CA 90501 •ph 310 782 2929•fax 310 782 22779-8 Outside Lab <br /> Client X SSoA Collector f J � f ! �'9'�Qy�2 Page Of <br /> Address /-(Z Z-0 4 aims'lae�4 41 d1C Client Project# 413' 4-5If?--7 Protect Manager 1`7 1ee- <br /> 42tr£GU, (-4 Location Oz SfsxL/'�-- /(,gLl l�f� <br /> Phone D Co 9 Fax rS 5�' ' D�°SS Turn around time S - ^��'`}'�� <br /> Noteso n � i a l^� �l � 82608 � Sample Receipt <br /> CL <br /> b Intact ❑Yes D No <br /> w ro � 50x1 Intact Ci Yes❑No 0 NIA <br /> {ct Cold ❑Yes p NoU on <br /> Uzi—' y � f a � T a- 0 b y NIA(Received on Site) �i <br /> C�1Ut C l o v ani vroi <br /> co <br /> Sample Container W U w <br /> Sample Depth Time Hate Type Type � w 00 � 0 o � ti uj Field Notes <br /> ('`�w-I izr� l zaoZ qz,0 V041x <br /> LJ-Z- <br /> fncu-3 !Z'15 <br /> z.50 <br /> �w-lo <br /> VW-( r 30 <br /> L Lri <br /> Reit (Signatur I ompan ) Received by (Si ature) E` (com any) Date Time <br /> Reli qui ed byv( atu e / (com any) R cety atura) (company) Dat g`J Time p, <br /> Reli cashed by (Sign ure) (company) Received by (Signature) (company) Dale Time <br /> S,grature constitutes authonzation to proceed with anaiysts and acceptance of condition on back Sample disposal instruction C] Disposal @$2 00 each Q Return to client Q Pickup <br />