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C)L d2S CHAIN OF CUSTODY RECORD <br />'NHITE WM-I SAMPLE • YELLOW TO CIJENT Date: Page ( of ) No. OF CONTAINERS TEMPERATURE PRESERVATION Enviro-Chem, Inc. Laboratories <br />1214 E. Lexington Avenue, <br />Pomona, CA 91766 <br />Tel: (909) 590-5905 Fax: (909) 590-5907 <br />CA-OHS ELAP CERTIFICATE #1555 <br />SAMPLE ID <br /> <br />LAB ID <br />Turnaround Time <br />0 Same Day <br />0 24 Hars <br />0 48 Hours <br />0 72 Hot <br />Other: <br />SAMPLING <br />DATE TIME Analysis Required COMMENTS <br />Owens-Water <br />(200928-12J <br />9/28/20 9am Liquid None <br />.97-29/zo 3:-so <br />Relinquished by: <br />Project Contact: Sampler's Signature: <br />Curtis Desilets <br />Project NameTID: <br />Owens-Tracy / Quench <br />FaxiEsyto,.envirocheminc@ gmail.com Water (200928-12) <br /> <br />wey4e <br />Received by Dale & Tree: <br />Company Name: <br />Enviro-Chem, Inc <br />City/State/Zip: <br /> Pomo CA 91766 <br />Relinquished by: <br />Relinquished by: <br />Address: 1214 E. Lexington Avenue Tel: 909-590-5905 <br />Received by: <br />Received by: <br />Dale & 'nue .2 <br />r):118P‘'; 3 :SOpth <br />Instructions for Sample Storage After Analysis: <br />0 Dispose of 0 Return to Client Store (30 Days) <br />0 Other