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Air Sample n tion Notice <br /> P linquisising signature on this document indicates It t sample is being shipped in complianceRAVINE <br /> SUITE S <br /> Frith all liable low, State, Federal, n tl 1, and int rnab l ul ti and � <br /> TOXiCSLTD. ordinances t any kind.Air Toxics Limited um no liability with respect to the collection, ,CA 9WO <br /> tterlirrg r slpplrig of ilx rr�a linc# ihirtg l incl` t tc hold I <br /> 000 FAX(916)985-1020 <br /> harittless,deftind,and Indeninay Air Toxics Urnited against any claim,demand,or tion,of any <br /> '• kind,related to the collection,handling,or shipping of samples,DAT Hotline(80011467-4922, Fuge _ cit <br /> Project Manager <br /> Project Into: Turn Aroundircle Reporting <br /> Collected by:(Pont and Sign) ° t° � <br /> Time: alts: <br /> .f6 $ llrrrrl <br /> A <br /> ;dire It I? � t dip . Projppbv <br /> ect tsll lfrn EgD/M3 <br /> Phone Project <br /> Tube# Date of Start End Final <br /> Lab I.D, Ftetlf,Sampite I.D.(Location) Dter n Analysis Requested <br /> Cartridge# Collection Time Time Volume <br /> =tA <br /> X030- its I I 1i <br /> VJ <br /> t : <br /> a, <br /> I is signature) l te/TiiReceived by.(signature) Date/rime Pump Calibration Information <br /> I - <br /> Pre-test Flow late; <br /> efin istt by: signatu ' Dat 1 s Receivedby.(signature) Date/TimePost-tet Flow Rate: <br /> Relinquished by:(signature) teem ei e by.(signature) Date/Time Average Flow Rate; <br /> Mortes: <br /> Tam rat ` i t1r ` <br /> No on <br />