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(*A <br /> 1117 [nuc1'aTC <br /> SAuite 13 <br /> IvftAlLSla,t::1 '/�1�t <br /> Company Name: Ass— -- —Project-Nane:O—� Ava✓uU - Ll9�Eff.cl[11�IC�1t <br /> Mailing Address: Lo71 Ad �Ur Billing Address (if different): <br /> City: IY\OASlate: Zip Code: 5 35 I " <br /> -- — - - _ <br /> Telephone: 269 54 9-2L-'L( FAX H: -269-5-19-Z"L"L`s P.O. H: <br /> Report To: , 1vI vj4 Sampler: -� ftoYts QC Data: Level D (Standard) U Level C U Level D A 10"; iI <br /> Turnaround AID Working Days U 3 Working Days U 2 - © Hours U Drinking Water Analyses nequested <br /> Time: U 7 Working Days U 2 Working Days U Waste Water <br /> U 5 Working Days U 24 Hours ).(Olheq`fj / , '" - • <br /> Client Dale/Time Matrix # of Cont. <br /> n ui enl ; <br /> Sample I.D. Sampled Desc. Cont- Type Sample N <br /> 2 F�-'I �•G�il�f F � r <br /> 2. MVsI )0 I <br /> 3. �� 1� l ✓ <br /> i <br /> i <br /> 4. <br /> 5. <br /> i <br /> 6. <br /> 7. • <br /> 8. <br /> 9. <br /> 10. — -- - -- -- <br /> Relinquished By:,A f Date: Time: 700 Received By: [tatr. (' / =r <br /> Relinquished By: Date: Time: Received By: - Dale I trn <br /> Relinquished By: Date: Time: Received By Lab: Dale: n! <br /> Were Samples Received in Good Condition? U Yes U No Samples on Ice? VYes U No Method of Shipment -FeA <br />