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California Department of Toxic Substances Control <br />Environmental, Chemistry Laboratory <br />700 Heinz Avenue, Suite#150, Berkeley, CA 94710 <br />SAMPLE /SAMPLE EXTRACT TRANSPORT CUSTODY <br />Receiving Lab / Section: <br />Sample Collection Site: La N- Dv -VA �9- <br />• OSC = original sample container; SS = split sample; A = Aliquot;. F =fractionated sample. <br />Release for transport by: Cz k L'rV) Ll <br />Time /Date i ��.2 07 <br />i <br />Transported to: Test Am7Fb/ A ec ab/ / Others <br />y: Fedex / Time /Dated zv C�l• 45 <br />Received <br />Time / Date <br />Returned to ECL by: <br />Time / Date <br />