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f <br /> 4 4080-pike Lane '° � <br /> iAlN-OFCUSTODY RECORD • . x IQ <br /> Concord,CA 94520 800.544-3422(In CA) pNDANALYSIS RtQUES?. 72- 12633 cus DY RECORD ? t <br /> r N V l!0 8 M r N I A 1 415.685- 852 800.423-7143(Outside CA) <br /> •_a C R -' k <br /> I F' 1 0$0 IIA l- INC <br /> Protect Manager. REQUEST <br /> ANALYSIS i' <br /> ^ a. <br /> ' J � PhonC#:`1�6-372- <br /> FAX x: <br /> vn i w ❑ <br /> r/G 3 �-7'ui w <br /> d M �r O s.• qr <br /> J <br /> Address- <br /> IIISite location., ohri Ino „ 13 <br /> I- <br /> 041 <br /> � <br /> P•ojeect Number. Pro)ec Name: d� m u o xm a❑ N O m I £ <br /> ! m n •� Y of <br /> E 0 _ ro <br /> 4)f��..++.ii []I*_fiy;r { j1 /y1/�3f,l�tLels.l 2 —n..r. r ~ pUzc =Fa-w-DI-a cpn o Ux' zx��ec=A —��dz`xc4 ❑3 mI❑-❑ a.� F = <br /> 0 V i0 wo❑m ❑wvN�❑m'7 j❑°❑�ul <br /> OogEthat the proper field sampling aSampler Name(Print); ❑procedures were Used during the collect+Qp m - m <br /> ❑ m ^ ❑Z[these samples. <br /> ❑��inG❑a_$ <br /> Tat'oalFedSource �C /-rlingSam le Matrix Q <br /> Lab# �CTEL !ttOd e 0 0 <br /> Ix <br /> ID of served pmmmN � ❑ <br /> am m <br /> tul ❑ amp'e (Li use <br /> onIY1 z Q M ❑ ❑ ❑ <br /> Q m ON s K11 ¢t! � 0 o NLu x ID CO m v,p tiO c -c a - <br /> : <br /> p. <br /> I^ fy�8cr3 <br /> w I'L 11iCelle, Uuw \ <br /> cc <br /> et <br /> �S /f _ _— _ —____ —t. _ _ •.fid I ---1� ❑ � d, tit .� <br /> lei <br /> - - - y .1M <br /> SPECIAL HANDLING SPECIAL DETECTION LIMITS <br /> P.t 1101 m,I 1 (ape ilYl REMnRKS' x fi r• <br /> I +t'I D f F D 48 HourS ❑Ll 2 <br /> 1 <br /> r1Tlr1 r2 <br /> r"1 BUSINESS DAYS <br /> '�t r){; CL rs Lrvnl f7 Blue Level Q "' - <br /> SPECIAL REPORTING REQUIREMENTS Lab Use only <br /> L tp <br /> fSpnr.ity) Y Storage Location <br /> 3 9- <br /> Lot it: Work Order#: `- 5 u '1 <br /> m <br /> ¢ rJ¢ Er <br /> - c <br /> y <br /> v 'I <br /> 5t <br />