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Batch M ATIVVD <br />112C0 Kirkland, <br />Kirkland Way 9W33 <br />WATKirkland, WA 98033 <br />CHAIN OF CUSTODY 425I65g92g6 <br />WATeedngLLGCom <br />BULKASSESTOSTEST_✓POINT COUNT I4Uo/600/109o)_TAPE _LEAD_ MOLD _ <br />Client Name: ServiceZter of Seattle (Everett) <br />Address: 1727 E. Madne View Drive, Everett, WA 98201 <br />Phone a:(425) 353-5586 <br />Project Manager: Tina Quarnstrom Email tquamstrom@smbysm.com <br />Project Manager Phone N: (425)439-6655 <br />lob Name: Ll Azl W ubs %;T YA- POR ,?/t 7dY <br />Address: City 5T Zip <br />SAMPLES: Turnaround Time: Numberof5amples:� <br />Condition:Good Damaged ✓Severe Damage <br />SEQ <br />$am le Location <br />Sam eDescription <br />Drywall (YIN) <br />Paint Texture <br />Notes <br />11141 <br />aTGNgy <br />2 <br />i[ <br />3 <br />4 <br />i7LlhsrJ <br />A. <br />✓ <br />5 <br />PY <br />6 <br />($ P I <br />7 <br />C,0 <br />8 <br />aU <br />9 <br />to <br />11 <br />12 <br />13 <br />14 <br />SS <br />Print Name <br />/��Slgmqture <br />Company Name <br />loans <br />rime <br />Sampled <br />Tine Quametmm <br />/D <br />Relinquished <br />Tina Quamatrom <br />Delivered <br />Tno QuematmIn <br />Received <br />S� <br />WAT <br />Anal etl <br />1 <br />WAT <br />t <br />titi <br />'ti <br />Reported <br />TL <br />/ Y <br />How would you like to be notified? Email L/ Phone <br />Washington A:eehm Term L1C nammem the aearel prmded are of a poll moral with the yye of mexom recommend In <br />malo morn. W21h, ulA:brsbrteNre uc a¢ep8 no legal nerponletlM for the yuroe for which the aunt use: thetW <br />real By gptlng on this Chain ofcurtMymm the tllem anal nelle a Wuhingtan klaneas hating U Nam and ad lent" that <br />In" one fray the ran mania. <br />