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Q <br />Mqgj 17 CHAIN OF CUSTODY <br />Sunipl_r: Darr ShlmFed <br />Telephone, AirbillNumbri. CLx. r <br />SHIP TO: sEND RkSULTS TO: <br />McLaren Analytical Laboratory <br />I 1101 White Roci, Road Chent Name: <br />Rancho Cordova. CA 9567.0 <br />3916363:, 3646 C'omian.: <br />Address: <br />Phone: <br />PROJECTNAMI : <br />LABOR ATORI PROJECf I I PI #; ;SGS P.O. <br />RelinquishedRerervedby: sw..R Date <br />Relnjyuisheu by ., -- Received hv: s,Sm.R, Date Timc <br />Relinquishedhy::,.�: R - —�--- — Received al lab by .;, a,.,., Date i <br />/or <br />ANALYSIS RFQt TEST <br />Sample ID �aJmpie 'I ype of Number of <br />Number Dewnunon Dal, Time ;AnalysisRequc•sred T.A'I Conlauxr Contamen <br />Special Insiruction,A rrnment <br />Sample Condo,. n Lll,-n Rrceipi <br />Rxper'ti d Atw�l urn -Around Times: <br />L.aboratory Dispositiui, Secur <br />1 = 6nmediale %rreniton: Rush; % 3 = SlandarJ: 4 = StandardStorage Refri£r•rator ID <br />?A hours 48 hours ,� I week ? weeks Slorape Freezer I[)_ . _.__ 5r' _ <br />McLaren Analytical Laboratory 11101 White Rock Road, Rancho Cordova, CA 83670 916.838.3G <br />