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`�--1 SEND RESULTS TO ALL PARTIES LISTED BELDI,M: <br /> Ryan Mock 209-858-6404 <br /> Ryan.Mock@Simplot.com <br /> J.R. Simplot Company <br /> P.O. Box 198 <br /> Lathrop, CA 95330 <br /> 209-858-2511 <br /> Project 1D Projects <br /> Name: <br /> Remarks: <br /> COLLECTED BY: <br /> SPECIAL <br /> INSTRUCTIONS: <br /> CAM 17-TTLC TURNAROUND O 72hrs Standard Rate <br /> ANALYSIS { 1 8 Metal TCLP TIME ( ] 48hrs <br /> REQUESTS ST"C 1 C >� ( ) 24hrs <br /> } Other,-Note above in Special Instructions Section Same Day <br /> 115 <br /> Sample ----_ Lab lD Collection Matrix Notes or Sample Map, Etc. <br /> Date <br /> 3 © <br /> UIC76 _1 <br /> Relinquished Date Received By: Date <br /> &Time �Z2 <br /> &Timer 3 <br /> Relinquished By: Date Received By: Date YT <br /> &Time &Time <br /> Relinquished By: Date Received By: Date <br /> &Time &Time <br /> Send Sample To: Enviro-Chem, InC. Laboratories <br /> 1214 E. Lexington Avenue <br /> Pomona, CA 91766 <br /> Ph: 909-590-5905 <br /> Fax: 909-590-5907 <br /> CA-DHS ELAP Certificate#1555 <br /> CHAIN OF CUSTODY RECORD <br />