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Creek* nvironmentaI Laboratory, ince CHAIN-uF-C 'DY <br /> 141 Suburban Road,Suite C-5,San Luis Obispo,CA 93401 phone(805)545-9838 fax(805)545-0107 <br /> ORDER # � <br /> Client Name <br /> Contact Phone Due Date <br /> C-nr Qf` `43^ S �Q 91/!0 5 S <br /> ormal T A Other <br /> Address City State Zip F9�la-9a�_33�// 24 hour 8 hour 72 hour <br /> 1:3;2C.0 ,v- AlrG t" Mel <br /> PO # Q/!5Cell I Beeper Copies To <br /> Project Name I Number <br /> &?sal-, * s /y-7s s' 1, <br /> City State Zip <br /> Bili to (if different from above) Address <br /> Sampler Name(Pent) <br /> comments Matrix Key DW=Drinking Water <br /> AQ=Aqueous SL=SodlSohd <br /> #of Creek <br /> Date 1 Time <br /> Matrix Bottles Preservative 1 Bottle Type Lab Sample# <br /> Sample Descri tion Sampled Analysis <br /> u-�0sel �Sa�s��M C-rps B�E)e(VO15/8Qaa U L a <br /> 2/)4/e T3E, Dry, aTSE , TA uF eS-2coa8� <br /> SC- 1 - y0 ' r�rorvw (. �1a1 ene,-�acl V+la '(4s C�d�l 7 ( x Vv IMeL <br /> 0 <br /> Sc-I — loo ' d 9vd <br /> Date 1 Time REC IVED Y Dat I Tlme <br /> RELIN UISHED BY Pr71 <br /> Frganization am-Si PrinlE7 ( <br /> t <br /> Creek Environmental <br /> Laboratories Inc <br /> FORLAB USEONLY Shi in Method Client ! Lab I Courier Sample Conditions Intact Y / N Cold Y 1 N CustodySealed Y I N <br /> REMARKS: <br />