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CLS - L&S CHAIN OF CUSTODA CLS ID No , hN22 4r 3�C LOG NO0898 <br /> REPORT TO CLIENT JOB NUMBER ANALYSIS REQUESTED FIELD CONDITIONS <br /> NAME AND ADDRESS CL LMS T1 „r', <br /> 3249 Fitzgerald Rd. DESTINATION LABORATORY <br /> anc -dove ❑ CLS (916) 638-7301 'm <br /> PR ECT MANAGER }{ 3249 FITZGERALD RD m <br /> ren 010 <br /> RANCHO CORDOVA CA (1) COMPOSITE <br /> PROJECT NAME 95742 M <br /> m <br /> SAMPLED BY OTHER <br /> JOB DESCRIPTION <br /> (21n )!'Ci I L <br /> C m TURN AROUND TIME SPECIAL INSTRUCTIONS <br /> N <br /> SITE LOCATION r r / <br /> rn a0 �¢ o� <br /> DATE TIME SAMPLE CONTAINER � � O <br /> IDENTIFICATION MATRIX NO TYPE <br /> 4Wo2_ 0,204M 1 -001 L HOOb <br /> a010y 0-11 _0 <br /> 020 0-IL7-0 01 <br /> cn <br /> f <br /> • 311U 17dZ3 INVOICE TO <br /> PO N <br /> QUOTE# <br /> SUSPECTED CONSTITUENTS SAMPLE RETENTION TIME PRESERVATIVES (1)HCL (3)=COLD <br /> (2)HNO3 (4) <br /> HED BY IGN) PRINT NAME 1 COMPANY DATE 1 TJMlE RECEIVED BY(SIGN) PRINT NAME 1 COMPANY <br /> rf m /Q5 410a <br /> RE AT DATE/TIME #`/ CONDITIONS/COMMENTS <br /> SHIPPED BY ❑ FED X ❑ UPS ❑ OTHER AIR BILL# <br />