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ENVIRONMENTAL HAZARDS SERVICES L.L.C. 7469 Whitepine Road Richmond Virginia 23237 Phone 804 275-4788 Fax 804 275-4907 CHAIN OF CUSTODY FORM Company Name Address Environmental Health Safety City State Zip Date Washington State University Pullman WA 99164 / P. O. Box 641172 Sampler Name EHS Client Account Phone Contact Name Project 49-3308 D Fax 509 335-5604 509 335-4442 Asbestos P. O. Lead Other Metals Released by Received by Signature TCLP RCRA 8 Waste Water TCLP Pb Wipe Soil Paint Air TEM Chatfield Bulk TEM Air Fiber Count PCM Asbestos Wipe Sample Number Date Time Bulk ID by PLM Specify metals below Air Volume L OR Wipe Area ft2 Scrape Area cm2 Date/Time Comments. O. Box 641172 Sampler Name EHS Client Account Phone Contact Name Project 49-3308 D Fax 509 335-5604 509 335-4442 Asbestos P. O. Lead Other Metals Released by Received by Signature TCLP RCRA 8 Waste Water TCLP Pb Wipe Soil Paint Air TEM Chatfield Bulk TEM Air Fiber Count PCM Asbestos Wipe Sample Number Date Time Bulk ID by PLM Specify metals below Air Volume L OR Wipe Area ft2 Scrape Area cm2 Date/Time Comments.

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