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e 5,`�..� -�'�: '-� ri �� r �,. _ •�. „��- ""� xis <br /> ENGINEERING <br /> INCORPORATED <br /> r S�A•MPLE CHAIN OF CUSTODY/WORK ORDER <br /> Clseni's Name - uY1i�/Q�' k 1 rl7E 11N ,, Phone-710"��� -dab J� <br /> Address 1 Ll 0& <br /> City,State,Zip BE tj I r �9�� s 0 -- — <br /> Client's or Representative's Signature — <br /> tsignalure authorizes the v:ork and terms listed below) <br /> 'Terms:Payment i5 due within 30 days of invoice.A service charge of 1.5%will be added to overdue accounts. <br /> —All samples remain the property 0(the client who is responsible for disposal.A disposal fee may be imposed if client fails to pick <br /> up samples. <br /> Pf10.) NO PnOJECT NAME <br /> tiA6,PL1. Is„pl,il.ioulf CIOjV <br /> . \ <br /> (o-G 1 CON- eE tAH s <br /> rAINERS \r �� <br /> y{q NL) DATE 11ME m STATION LOCATION q <br /> t <br /> I, 1 <br /> 2 2 LLL� ' !, <br /> Y <br /> RlhOd W5lt q by f Sig,d W'v 0-- T.— RPSOrvaN pY lSq ndlurYl DR[YiNG TI►IE. <br /> _ <br /> -- <br /> . �—r—•�__ r L16,L- <br /> _ <br /> 1!r. t' ! C.��Il IAnT FIr11::N_- TOTAL <br /> �/fjfir)} _— <br /> ,qur�netl by 6sgpwhn cl Wlr Turin Prc..lrcf by IS•gnnlwer SITE TIME <br /> STAnT. rIN35H TOTAL <br /> It,IIII.I'I,�luV IrY Itis frl.11�rul -D,III• [IIT' ite---J{:Y TRIAL IML ILLS IIUU11=MILE . <br /> P O.Box 5853 0 Concord.California 94524 a (7071746-6699/PAX(7071746-6815 <br />