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r <br /> Chain of Cueody Record Date <br /> 148 S Virtewood St, Escondido CA 92029•ph 760 735 3208•fax 760 735 2469 HPL Project# _US c� " <br /> 432 N Cedros Ave , Solana Beach, CA 92075• ph 858 793 0401 •fax 858 793 0404 <br /> 2373 208th Street Unit F-1, Torrance, CA 90501 •ph 310 782 2929•fax 310 782 2798 Outside Lab <br /> Client �G r{^fiz Collector s ��p/1 Of <br /> _ Page <br /> Address UL' G�( III-.4K/L ZZIC O ClientPraect# ��7 adZ5 SCU CCr✓i <br /> 1 Project Manager— T <br /> GAJ ZrZ Location 104i'7�' <br /> Phone " - 06-/Z— Fax gr�if 'S-6,�—G:f�9 <br /> -- ._...� Turn around time :5w--lq�✓/���� <br /> 0 82608 Sample Receipt <br /> o uu <br /> _T 4 <br /> o � Intact Yes �No <br /> W <br /> rn W 5ea4 kD Ct Yes No =N A <br /> -- 6 ° = <br /> Cy <br /> - _ o T N X altl -Yes No <br /> W <br /> O N C <br /> - 0 0. m w N A(Received on Site) ° <br /> _ ar ro <br /> X p 00 F C C Ur p <br /> _ Sample Container = N y <br /> Sampie Depth Time Date Type Type as m 0 � 0 0 0 X Field Notes <br /> Wkq <br /> J9 1U 5)i A L U7,v V05 ?� <br /> 1 pd <br /> )3qu <br /> ft-/- -_ <br /> 1-71 <br /> Rehngcished by �gnature (company) Re i d by (Si a ) <br /> (company) Date Time <br /> -- d ✓' �G t l�t YV�/!` 3—�`�r y r`rJ S CMZ C i <br /> Reh a he v (gig to (company) ive b Sig lure) <br /> (company) Dat Ttme <br /> Relinquished by {5gnature} coin an Re erved <br /> (company)Y) Y ( ignature) (company) Date Time <br /> Signature constitutes authorization to proceed with analysis and acceptance of condition on back Sample disposal instruction Disposal @$2 00 each Q Return to Ghent 0 Pickup <br />