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ASsOCLAMLUOPATORW Chain of Custody Record 2-70 <br /> m "North Brtavia•Orme,CA 92868LA\ Lab Job No, <br /> CD FbDne:(?14)771-6" • F=n (714)538-1209 Page of <br /> m <br /> CD <br /> Li CUSTOMER INFORMATION PROJECT INFORMATION REQUIRED TURN AROUND TIME: Standard: <br /> OOMPANY 0 SE�2VICn/L P90,Fr NAME: Sn2o r kT,.l p9 tnlA L- rz Hours: 48 Hours: <br /> 24 Hours: <br /> SERDREPORTTO: ��STr 11t NUMBER: G�2� <br /> EMAIL- 1 }f i j Z .G,,r✓1 ADDRESS: <br /> ADDRESS! <br /> PHONE: / l� Z�8"1 2• SAMPLED BY: dao <br /> �Y <br /> Sam pie ID flate Time IHatrlx Container pies. <br /> Number/Size Test Instructions&Comments <br /> 1 f <br /> Ln <br /> fx1 2 <br /> Q <br /> 3 <br /> H 4 <br /> a <br /> v s <br /> D <br /> LO — -- - <br /> � 6 <br /> Q - <br /> I <br /> io I <br /> 12 --- - <br /> �r _ <br /> 13 <br /> r- 1 <br /> � t <br /> r-- <br /> Total No.of Samples: Method of Shipment: Preservative: 1=Ice 2=HCI 3=HNO3 4 =HzSO4 5=NaOH 6 =Other <br /> GD <br /> heti by 1. Received By: 1 ReFnquished by ' 2, Receivad By: 2 Relinquished by 3. Received lay: 3. <br /> SI re: Signal e: SignalurQ: Sipnatve_ Signawre: Signature: <br /> (lZ Printed Name; Prins erne: r ! Printmm <br /> Printed Nae: Printed Nae: Primed Name: Pinted Isarne: <br /> Date Time; Date; lime: Date: Time: Date: Time: Vette: Time: Date:CD <br /> Time: <br /> CD <br /> a <br /> Distribution: While-Laboratary Canary-Lakiwatory Plnk-PrsWVAccaunl mruser Coidanrod-SamploODrlglnntor <br />