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CHAIN OF CUSTODY RECORD <br />- SGS North America Inc. <br />J 1501-A Easl Patapsco A,:enue Baltimore- MD 21226 Tel (410) 355-1958 Fax r410) 355-1965 <br />-1P0 Box 850 Sophia, WV 25921 Tel (304) 255-0422 Fax' (304) 255.0417 <br />J 216 Oxmoor Cucle Birmingham, AL 35209 Tel, (205) 942-3120 Fax. (205) 942-0914 <br />-15793 MacCorkle Avenue SE Charleston, WV 25304 Tel (304) 925-6631 Fax' (304) 925-8877 <br />J 2978 East Center Street Conneaut, OH 44030 TP1 (440) 24 ,2R1 Fax r44m"x'14-2808 <br />J 1101 Homard Drue Deer Park, TX 77536 Tct 12811' '(,-1L'l'i I-ax i2`;1} 47ri_4 +i<,) <br />J 4665 Paris Street, Suite B-200 Denver, CO 80239 TPI i?03) 373-4772 Fax (',>,0;3) 371-471)i <br />..1 2804 Hackathorne Lane Gillette, WY 82716 Tnl CW-'7 ti8I-7917 l-ax 131.)7i 6K-7051 <br />J Route 2, Box 1(32A Middlesboro, KY 40965 TPI 0 ;06) 248.4205 r Lu (ft)g, 24,3.0044 <br />J 15550 N Lombard - Terrnulat 5 Portland, OR 97203 TPI r`,0,3) I-ox (5,011 23S-5026, <br />J 16130 Van Drunen Road South Holland, IL 60473 Tel i; OSt 3.;1-I'-100 lay r 7r;8t <br />F r-+ <br />IF NT M-f'-r&w 1_.U S LO <br />SGS Reference. <br /> <br />? <br />'-.iNTAC.'T ? ` PHONE NO.1 70 g`47s?o ?C??/ _r;F <br />PAGF <br />l ! Ci <br />r <br />ir ns <br />h):;) If ; f 5lTEiF`VJSI 7# ?.-?- N o RAW E <br />TYPE e e <br />a <br />usM <br /> analysis <br />I?FPOR IS 70 <br />a (3o - G <br />t <br /> <br />CoL*PMO &t LtX NO. (if 70 S !o X j 4 4 C <br />o <br /> <br /> <br />N <br /> <br />c= <br />COMP R,v)irrwi <br /> <br /> <br />0 <br />JL'nlr'F 10 S uK &L <br />_$ QUOTE# r-w-r <br />Po 6D%. 'f- imr y <br />4Pr? NUMBER ?-? <br />1414_ <br />2 <br />4 <br />I <br />N <br /> <br />E <br />GRAB <br />-'y <br /> <br />t AP. NO <br />SAMPLE IDENTIFICATION <br />DATE <br />TIME <br />MATRIX R <br /> <br />J <br /> <br /> <br />F„MAF2KS <br /> ?I>r-* 0o o, t 17, coo A 2 G <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />5 4 <br />she :(1) Dale Time Received By Shipping Carrier: <br /> <br />Shipping Ticket No; Samples Received Cold' (Circle)tYES .4,10 <br />u <br />T mperature C <br />2) <br />r Data Time Received By: Special Deliverable Requirements Chain of Custodv Seal Wircle) <br />INTACT,' BROKEN ABSENT <br />rP?-:-linqw-,hedBv: <br />3) Date rime Received By: Requested Turnaround Time andSpecial Instructions <br />4) Date <br />No Time <br />l ?: ? Recei e <br />4