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Date: / ' -�� THE TWINING LABORATORIES, INC. Page_/_of�_r. <br /> 2527 Fresno Street, Fresno, CA 93721 <br /> S i l - (209) 268.7021 <br /> Chain-of-Custody and Analysis Request Record <br /> Project Name: �/(t rte•' Project No.: Project Manager: <br /> G <br /> Sampler: `�'1 Company: r�_z .,-�L - Phone: Del. By:�ri s <br /> i <br /> SEND REPORT TO: SAMPLING LOCATION -OR• BILLING (Circle One): EXPECTED TURNAROUND: <br /> Company: Company:_4th Rush <br /> Address: �' f`� Address: ;��� Routine <br /> , <br /> (Specify Time: �) <br /> Contact Name: ��'� �- r ,v 7 ` Contact Name. <br /> Phone: Phone: <br /> COPIES TO: <br /> Analysis Request <br /> Number of <br /> Lab' Client Sample Sample Dat€/Time Containers <br /> ID N ID N Description Sampled Analysis Requested Per Sample ', <br /> _ -s'/ - s.-r�� 5/� > _/' ._. -'k �n i/-F•l%�%f� �'i`f r�'- 'i r'1- �r-r, y <br /> i rn D—f i�l -/JOT//rZ <br /> n <br /> 'Lab use only. <br /> Re tnquls hed B i'.AffiliatloB, Daterrlme RBGe. d-B Afi Tallon aterrime <br /> � 4. — <br /> 'Roceivod By Daley Recoived In Lab By Affiliation Date <br /> lTime <br />