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<br />i <br /> <br /> <br /> Priority; RoutineExpedited Special <br />C&2Q <br />Received/Relinquished by: <br />Received at Laboratory by: <br />-------7 <br /> I__I <br />Rev. 0/0 <br />Laboratory: <br />Carrier: <br />Waybill No.: <br />Company <br />C-- <br />ished Time Relinquished <br />’I ^-'lo <br />—■■ - I “QI <br /> <br />Date Received Time Received Date Relinqnishe <br />K <br />Sample Hazards: <br />Notes: <br />CUSTODY RECORD <br />Originator: <br />USKOMOQ <br />• • •■.■ •• - v - ■ . ■ .------------------ <br />.••.•• • ••».• ' •• •. .• fr •■ -k ■ ■ •• - r.. ■ '• • <br />••. •>>.< . ’ ' * l’. ’ . • • 1 ‘ ' ■*. ''■ • *«", • • ‘ ■- ' . <br />_Z^ p <br />_Project Mgr. <br />DIETZ ENGINEERING AND CONSTRUCTION, Inc. <br />Transmit results to office checked below: <br />33233 South Koster Road, Tracy, CA 95304 <br />Voice: (209) 832-2910 Fax: (209) 833-1288 <br /> 1120 Hollywood Ave. No. 3, Oakland, CA 94602 <br />Voice (510) 336-9118 Fax: (510) 336-9119 <br />Project: <br />Project No.: <br />Sampling Team: _ <br />Site Global I.D. No.: <br />Si <br />Signaturo <br />. I; btvt <br />yo £>/^> <br />Print Name <br /> <br />jcyrAreHubmil l'M/08 <br />Received/ Relinquished by: