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Contacttis: . <br /> Nevada: 3151 W.Post Raad,Lasyegas;NV 83118 <br /> P:702.307.2659 T.702.3072591 <br /> ASSET LAB-O.RATORIES CHAIN OF CUSTODY RECORD Callfomiw11110Artesia Slvd 5te.B•Ceriity5,CA90703 <br /> ANA V i„A,.suranori sflvr fS MA_rr<.r:Not0? ii 5 P:552.219.7435 f:562.219.7436 <br /> Nay, <br /> Pagedt 5, <br /> www.assetiaboratories.com <br /> C134gt: Report W: - Bill to: / <br /> '�+:""... �,..: ._. E01?Requlrsmant QPYLiC SampgRece'sptCand3Gan <br /> Addro:is: # _ ,{ Company: ~.. Address; - - EXcel Ebt3 :f3TNE <br /> " s av.,1&: - d '-4GBAVad48r ❑ RwooB - ❑ 1:chilled ❑. <br /> Addreea: - Email: Lab.speC Cal Trans :2Meadslce ❑ - <br /> " Othem ❑ Lem ill ❑..3..Conla*intact jW ❑_ <br /> Phow -- - - Pax: AdiFrees: F47Mdto: PE3d Specify <br /> -LEVELIV © 4.Seal present <br /> Regulatory ❑ 5.R ri tuber <br /> Submitted By, Phone: Fax: Globo#0: Spectly State: a.talau,od of <br /> Title: --• Phone: Fax: Sample Temp: <br /> �,�, flr;{. Matrix Analyses Requested � <br /> Signature: Data: Sampler's Signature and Date: Ground © ssd3rn.af © - L✓„ <br /> "-o......�"�•-.» ✓!�'° PotaGie El Soft Cr}t n.er..=...... <br /> 1 herabyr 8' a ASSET Labs to perform tfre tests lndlca y <br /> Project erne: ..."_. NPDES © Qther © w, .� m ZO ilfn <br /> solid E $ Tracking No. <br /> l attest hs vaircfily amt euthanficq of thm sampla.t am aware that tatnparing Surface Eti. <br /> _ w(M orr t3frorrarty rruatanelfng trte sample mre/ron.data or fime ri/cnllacrron is ❑ f'' v g. & W <br /> mnsiderad freutl and may be grounds for kgel avA'vn _ o ;}g <br /> LLI <br /> PrpejatNumbsr. E o cc <br /> Sarapter's Naive: 1E z U 0. <br /> iEefn Laboratory Work Order No.:' sampte iD"cation Date Time Water Solid '± Others Remarks <br /> No. <br /> 023518 - 39 Dd. <br /> - 4 ` <br /> 3 - 41 <br /> 4 - 42 -3 " <br /> 5 - 43 , I <br /> 6 - 44 <br /> - 45 — <br /> B - 46 <br /> 9. - 47 — ®°10 - 481 <br /> Relinquished py(Slgnalura and prknlad Noma): Bate PTfma Fi- lSignatLrra a nfed Name): Bate 1 nrre -- Turn Around Time(TATj Special instruction: <br /> Ar � ' itlr? 'i: ❑A t 24 Hrs or same Day TAT <br /> . ` ❑ B = Next Workday <br /> Relin 3s by <br /> is and"ed Name1 Date!Time Revery by lgnatu and Pdnted Name}- Date/Time <br /> y ©C = 2 Workdays <br /> r 7 fT ❑0 = 3 Workdays <br /> Relinquished by(SignaWre and Printed Name): Date 1 Time Re ad by(Signature and Printed Na }: Date!Time <br /> © E = Routine 5-7 jlJtxkdays <br /> TAT Starts at$A10 the follow}Ing day R <br /> samples fscelvgd gttor.341ePM. <br /> Terms 5,TripPreservatives: lContialnerTypo: <br /> S AS minple6welt bt_dixPvsed k�.g5dnys upnn.:ceipt endrecaraswi36e dwhoyeIIln Syeelsoponsuhmhskm M r.,10 llpO 6,kS5E3 Lebonrarin'n noE s'espnhslh$rorcempicecaNeriMvsin63nm xmc�rmdmosr. <br /> 7.n�samra� s-7ewcx:aen.nna.�.aii.pyye«Wsnm•Hir 7:7--mn— H=tCl.... .'N:=riNa .s.=thSOF C=4^C IT-Tube IV=;1t]A P=Pint <br /> Lentn.nz4 Hn=zaps Nm n.v-IDi1% 4Wmdayc vzow aafrrp��:,.Pu,gAdnzd�.i�,t.�n;rta:.,,,l.w�YMr Mr.SSE:rini�..�.��ie.sih.rar.�,r nr Rvort..ecdea, Z=7.frEAC)z O=NamHT=Na.S20,1 IJ=Jar I B-Tedsr 10=Glass <br />