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Report (61) I7 -?a,c\%- i:, 6)- 1 CA,Labs,LLC. Phone:225-751-5632 CA L 122321ndustriplex Fax:225 7515634 Suite 32 Mobile:225-993-3471 Baton Rouge, LA 70809 ?.....,12....,r-,,F ,1 z Novh ?.O18 Chain of Custody q9.y I-YOF i!GA ori/ Client Name: 1 Kelsay Environmental! I CA Labs job# CBR t; L :Al- Client Address: 833 SE Main Street 1 Billing Address: same ! Suite 410 (if different) Portland, OR 97214 phone number: 7503-705-0514 fax number. Send Reports to: Brad/Lisa Project Number: Project Name: gar, iti(01 s i ri,tri !Brad KeIsay - - _ ___ Reports Results_ Contact I VIA: EMAIL FAX VERBAL Total#Samples pubmitted: Total#Samples to be Analyzed: Material Matrix: G' lc Air/Bulk/Water Asbestos: please call ahead for availability of all rush andlor after hours samples. TEM 'TA Time PLM TA Time Optical/JAQ TA Time Girth analysis arrd TA time Circle analysis and TA time --2 hour. Allergen Particle: 2 hour AHERA 4 hour Improved 4 hour tape/bulk/swab 4 hour EPA Level II 8 hour Interim 8 hour Cyclex-d cassettes 8 hour Drinking Water 16 hour 16 hour Air-o-cell cassettes 16 hour Wipe 24 hour AHERA 24 hour Anderson cultures 24 hour Micro-vac 2 days 2 days Bulk/swab cultures 2 days NIOSH 7402 3 days Point Count- �"'1 ays Bacteria cultures 3 days Chatfield Bulk 5 days (NESHAPS) 5 days PCM:NIOSH 7400 5-10 days Lead: cads analysis and TA tine Matrix: Paint Chips Soil Air Wipes Wastewater TCLP TA Time: 8 hour 1 day 2 days 3 days _5 days.._ _.._-_6x10 days Sample Information: 1 Sample Number: Sample Location: Sample Date/Time: Sample Volume(L)J CSD i rrJ1(y& !al heft 'i?91 -t to/?1 A.., 040,,2 1) t t t cava i 1 yin ('ue _ k : sP1 9 tum 00y) 00S 77riiA._e_ t-(`ya' tAki- !heel Ii‘A3 iiitc 3 tdatalwordprolforms\ChainofCustody.iwp Revision 2 3/12/01 Page 1 g II '�g Custody Information; J `i Y,AitjLii!seived:., jafienlik-Adieture/Date/Time MO Signa 'Ij1'`/Date/Tune Samples relinquished: Samples received: Signature/Date/Time Signature/Date/Time 19.9..q2 lndustriplex Phone:225-751-5632 .-?-r". CA Lab Suite 32 Fax:225-751-5634 Baton Rouge, LA 70809 After hours Mobile:225- "" f ' NOV 1018 CITY OF i`t A ' `4 L111ij1NG p31 Sq4'Th 1 1C.Q, 74\01-znytip44-1201� (4?Client Name: ��(.�C� CA Labs job# CBR Client Address: 0 Billing Address: (if different) phone number: fax number: Send Reports to: Project Number: Project Name: ?Q'-e, fha cA%n er/ Reports Results Contact: VIA: EMAIL FAX VERBAL_,_ jSample Number: Sample Location: Sample Date/Time: J Sample Volume(L)1 7 Le ' AezzciA i n.Q ' X2, f 1 mi (1 c'e Uar� -3-x'1- ' ' XD 7 Me2P a •'l r'r� ' ctoM 611e64-611e64-v t'vt.y i ` i 00 t # 11 /1 I G> 09 -2t n t'Ka. Sari fig( C sek- 1 4-JI, 1 VA ..aIlt -k all b * i 'c 91 Q ZQ � kv�=� oil I 1 te,x-\ _/watibrid f -c II ti t 'I dt 3 Main Le c-e) pieki 5ineet- x)'x'`11 al 11 ,, " lr it t ©I . eu4 e it t'ac. ' c- oJ (9 1 ii. - -- ce.1 b � � /osto t"7 it i it 11 01 g' . fair\ leu-i. r el\i n "fie-t\f t'C(1.,t-n1 I I rd c ''/''n at It It '1 ,t ') ( ' i. 5_ oaO MA 1-ev -k roc.e nce oWices 4JLjfri tont 1 i � a� 1 " if ' 31 '' ©� ^� ll 1/ t ) /I /, t 3CT N1aftt it,U-t) .U.l t )Se Csq c-r _ +n,,'i-0100,x- v_i yi-�i tl%i e _ _oc ti tr `r ii it It r1 C24S" Tkai4 xe cea 1 r, x reCA_XX \ cec'[t r For internal use: Any initial changes regarding project(indicate yes by checking line) ghailk Custody Information: Yiair �''�� j J�Samples relinquished: it /.i A._ IA received: j��'?i��l Z if grao „ ~`•� � Signature" /Date/T' e S r"'E�'S'1`-/Date J e1974 Samples relinquished: Samples received: Signature/Date/Time Signature/Date/Time