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SPL, Inc. SPL Workorder No ff H_ 08776 <br /> az of Custod Record ��Q 1 page L o f I <br /> e Anal sis Request &Ch n I <br /> Chent Name <br /> matrix bottle size pres .J, Requested Analysis <br /> Ln <br /> Address Phone �� 't' r pis 0 � > `tel, '� L , <br /> 1.4 II M <br /> Client Contact {`�YS 0-"pL:.� o z 1„ ` O <br /> rZ V J <br /> Project Name 11 `1 11 p �y G 4 p <br /> tA0 � > <br /> Project Number � � ip N <br /> Project Location S�""oG +.yt a? -, v, q� r' <br /> 3 c o U N aj <br /> S' <br /> Invoice Tov� II Il CLI Go , Go x x <br /> SAMPLE I TIME comp CO II M ZrA <br /> —( &141q) a Y <br /> MV <br /> --3 <br /> Chent/Consultant Remarks C,w f �(jk � Laboratoryremarks Intact? Y ❑ N <br /> �?( 0,05- 7n �Je Temp <br /> Requested TAT 5pecral Reportmg Requimrnenu Fax Results ❑ Raw Data ❑ Special Detection Lirruts(specify) I'M review(initial) <br /> Standard QC ❑ Level 3 QC ❑ Level 4 QC ❑ <br /> 24hr ❑ 721ir ❑ 1 Relinquished by ler date time 2 Rccezvq by <br /> G14 �6 160 e' CA) <br /> 48hr ❑ Standard 3 RelmquishedK date time 4 Received by <br /> Other ❑ 5 Relinquished by date time 6 Rev ed by boratory <br /> ❑ 8880 Interchange Drive, Houston,TX 77054 (713) 660-0901 ❑ 500 Ambassador Caffery Parkway, Scott, LA 70583 (318) 237-4775 <br /> a . ❑ 459hes Drive,Traverse City, MI 49684 (616) 947-5777 ❑ 1511 E Orangethorpe Avenue, Fullerton, CA 92631 ) 447-6868 <br />