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Date: �U (p C / THE TWINING LABORATORIES, INC. Page--Lof <br /> 2527 Fresno Street; Fresno, CA 93721 <br /> (209) 2�8a021 <br /> ^ Chain-of•Custody and Analysis Request Record k � <br /> SGrv,,/IN� } lYv1L (�SIS r 1 �- <br /> Project Name: IZI ll S; vy'-• C?. tc✓ Project No.: P l E wow 0+A ✓ Z 44 1 \ Project Manager:- <br /> Sam p I a r: <br /> anager:SampIar: E _71f ^ ter Company: -if-w i; b GL�'o vl2._S_ `-Phone: -S -0 qG A 9 Del. By: <br /> SEND REPORT TO: ArJ a f) 5 C MPLING LOCATION OR- BILLING (Circle One): EXPECTED TURNAROUND: <br /> / <br /> P '�iAC' l.aL,� � � ICC Y�L! se✓�r;e Ce,•k+/ Rush"�. <br /> Company: Pc c 7 C Gc t )c<�� c Company: I C <br /> Address: <br /> �„ So „O 5 + ✓e< Address: 1K) 5Jl �, lI ;ht:cy 1ZG ✓ Routine <br /> r ✓t5 of u rc (a 0 H1a✓id ec � , C ✓4 (Specify Time: ) <br /> Contact Name: Contact Name: <br /> Phone: Phone: <br /> COPIES TO: COl�nrt7 c / Sc o JlnGa u , <br /> Analysis Request <br /> Number of <br /> Lab' Client Sample Sample DatelTime Containers <br /> ID If ID If Description Sampled IcyBAh ; Analysis Requested Per Sample <br /> ' <br /> )•-S-aft/ T <br /> A)_ ZwS <br /> 'Lab use only. n <br /> 1.t LtAr. )l l-. to C —11i n" Affiliation <br /> DatelTime/ <br /> -Relinquished By Tfiliation DatelTime Receri a By <br /> /�/LG//�l �� -�� 4' DatelTlme <br /> 2,�" ..ved'By Affiliation Date Ime Received In Lab By Affiliation <br />