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I <br />yY.E.T. ~~ 111 IIIIIIIIIIIIIIII <br />tr.~r a r~,~ .~ war sar iw.r~. s o,... u~ ttt~mm~~~u ra nan :~••~ <br />Chain of Custody Record <br />3ampb ~ Ikte Time Compoaita/ <br />Grab Location __.Ata~b ........ <br />Requeated <br />dpaes z.~ ~ % G 0 <br /> v.• t9~v, <br /> <br /> <br /> <br /> <br /> <br />~umnle C'.iLCtluly Recnrd <br />Relioq ' Received by: Datdl"moe <br /> <br />Rel'aiquished by: ~ nat~!]"mx <br />u~ . z~. ee ...__ , o ..... <br />ltelinquishod ly, by: Aatdl"ave <br />Sample Rxeivod is Lab by Date/1"mrc <br />Cc•LL/ 3-Zl-oa <br />Comments <br />~.-Temperatune Received in the Lab: ~ -- - _... _ .. _. <br />Effluent: Oa J - ~, 2~r,,~sua - t .2~~ -- <br />Receiving Water. <br />Samvle Information <br />