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CHAIN OF CUSTODY <br /> Remedy, 1 <br /> Cite S ?fi t 4. <br /> 3$05-3 Davy Ct , Fremont, CA 94536 <br /> Project Name Telephone/FAX (510) 791-7157 <br /> Prcject Number n5. Laboratory <br /> P eport Results To L14s Name Cc ado w ���„ 4 a <br /> Sampler Name C Address <br /> Turn Around Time Telephone Fax <br /> ANALYSIS R t:1UESTED �"'� <br /> SAMPLE DATE TIME LOCATION SAMPLE i' D '4t I "y COMMENTS-DESCRIPTION-SPECIAL INSTRUCTIONS <br /> NUMBER TYPE QO''Lpr�'ru� ' �a•' <br /> -PT-r}, 75 77-4f 1150 <br /> C ,2- 77 i CpT 12 X <br /> Cf- <br /> Cer 1 ? a . 7 y GPr- <br /> r/T-l�- 70 -714 C -/;I- �,&.J <br /> IL <br /> SAMPLE RELINQUISHED BY SAMPLE RECEIVED BY <br /> Print Name Signature Date Tim, Print Name Signature Date Time <br />