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CHAIN OF CUSTODY RECORD <br /> Bill To: C / <br /> - � -- <br /> � - <br /> Sherwood 8071 N. Lander Avenue y'�c � C1 Cis <br /> P.O. Box 937 <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention: Phon <br /> C O R P O R A T I O N FAX (209) 667-2581 Page ( of I <br /> Job Number P.O.ft Project Name <br /> �'\, Z SSELI- (WOODW ftf� \J co <br /> Samplers:(Signature) Site Address <br /> ,�t„a,,,a r✓.�r ,s�.J g909 E. a wAQ>aAk-, qt hu ��' �J <br /> y <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE SAMPLE ,-V' <br /> (IDENTIFICATION) (MTH/DAY/YR) (HOUR/MIN) CONTOAINERS COMPOSITE)OR <br /> ITE) MATRIX �� Q� �/ <br /> Q� REMARKS <br /> 5 C3- 8 CHI' Ok JE61pp 1030 1 G-f-n d '�W t t. _ <br /> S3-9 9-11 (, 915- <br /> -sz-Io q-1i' 11 46 <br /> 5B-10 1 I�� 11 123a 11 11 1 Ot ! <br /> it <br /> 58-10 z-4-Zto' 1A 10 I I I >✓� ? <br /> 5a- kt of Nk' `I (S I1 I 1 I <br /> X <br /> a5 � <br /> Relinquished By:(Signature) Date/Time <br /> te/Time ` Received By:(Signature) Date/Time <br /> TURNAROUND TIME <br /> �I (Lia L <br /> Rehn uished By:(Signature) Date/Time R6ceiv By:(Signature) Date/Time 24 HOUR ❑ <br /> �d l a7 w /�3s` �LI, Co�• 7 48 HOUR ❑ <br /> elinquished By:(Signature) Date/Time Received By:( ignature) 'Dateime 5 DAY/X <br /> DISTRIBUTION: Original-Accompanies Shipment Canary Copy:Sherwood Pink Copy:Sampler NOTE:Samples are discarded 30 days after results are reported unless other arrangements are made. <br />