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NVL Laboratories, Inc. <br />4706 Aurora Avc. N., Seattle, WA 98103 <br />Tel: 206.547.0100, Emerg.Pgr: 206.344.7g7g <br />1.888.NVL.LABS (655.522'n <br />cue�� <br />Address <br />Project Manager <br />Project Locallon <br />CHAIN of CUSTODY <br />SAMPLE LOG <br />1 \,L - <br />I NVL Batch Number9 - � ��� <br />G'— I�D� ICS ClientJobNumber �� `b� �5—� <br />13a1 a--S�l� �lw��S�' <br />Total Samples � � <br />5 a,,,,,�.�,,. �„� ; 5�, w A 9�° �S <br />"7'ype of Analysis (check one) <br />� �—� �� l�� �,,, ASBESTOS LEAD �rb) <br />— F U�-�h2� � F S S ❑ PCM(aid ❑Paint Chips <br />� r�Mro�ik� ❑so�r <br />Phone Number � Z S—�� r— � 8 7' ( <br />CEl�umber ti 25 -�.3'i - 0 7 5 8 / <br />h�Number y Z� — 3 S� � p[i � I ('�� J <br />� l. <br />Condition of Package: <br />i <br />Z <br />3 <br />4 <br />5 <br />6 <br />� <br />8 <br />9 <br />10 <br />[a6 use orcly <br />ars <br />2���5 <br />2t9� <br />Clients Sample # <br />1 — , �, <br />�� - ,2 - I <br />4 —3—� <br />y-3—� <br />�i — �1 — I <br />� "'_ s�. I <br />W - (� - I <br />4 — 7 —1 <br />4 -e � <br />� — 1 —� <br />Turn <br />❑ 1- Hr <br />❑24-Hc <br />[n6 use only <br />.0 <br />ii <br />�Z <br />13 <br />�4 <br />�s <br />16 <br />» <br />18 <br />19 <br />20 <br />❑ Dust/wiye <br />❑Air <br />❑ TCLP <br />❑Wasle Wqter <br />7und Time (ckeck one) <br />❑2-Hrs �4-Hcs <br />❑ 48 - Hcs �3 to 5 day; <br />Clients Sample N <br />y—lo—i <br />4—Ia 2- <br />4 — I� —I <br />_' <br />�.c�inb�rvJllW(;flUNS: � � . ' <br />Na �ci al ` SA^^.� �.e S� ci a ti�� c� �s�j -aSe w_�:l o���ava-� �Ta�. <br />Lln(ess requested in writinA, af( samples wi(1 be disposed two (2) mceA;s after anal�sis. �`� `e S ;� W�'a � roensoo <br />