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CHAIN OF CUSTODY i LABATORY ANALYSIS REQUEST FORK[ w <br /> 6(b . c <br /> 1433 North Markel &rulevard,Sacmimato,CA 9$83+8 Service Request KD � Purchase Order J•�-� <br /> 90,CHI {9115)928»3300 FAX(916)!n&3341�. _ Lab LIF&W A <br /> Proles I Name Don 1b)germTJ _ Anal srs R nested <br /> Ptolecl Humber 22613.100001 � c <br /> Pmlocl MlanagV Dea,nnR Samoa <br /> Company EMICON-Pinnarie <br /> Address 1433 North Marllet Boulerard •`� o <br /> Sacramento,CA 95834 <br /> Phone (91619:.8-3300 a 3 <br /> FAX (916)92&3341 <br /> Saroplel's Stl�tature / J <br /> 4' REMARKS <br /> S.W11TI SmpleC®cuoaT)mI <br /> ID Dane Tune ID Mainz - "a Ha Presernnoa* <br /> MWARIt• ovyj water 5 3 1 a <br /> a <br /> -- rn <br /> RgLINQW4,WA I Y Ft9cmPED BY IxS1.Q+1QUtS11133D ey RFCRtm fly 'lLrR14A>ROUND REPORT BEQWRORNM <br /> RSA2[IlREMWf'C 3; I RarteM Regal <br /> Sew��'e' 5tig tun :isgfl S�g1►ah►ta 1410 fsu sry 11 Rom(W4jdm DllP,MS <br /> 2.4 (-JuuwayAqu MSO,ea requuad,may be o <br /> Pnak� Prv*W Name P mind Name Pnwcd Pique 'Nov*v0"p" s.dw cNwvd as mmoks) <br /> .�...-_ hWftWAXP.L% n9Ama ill DAAVandalia%R%pw <br /> Fum F'um Firm Flun foxiudem All Rasp Date) <br /> �4f C o,,v R wQCB <br /> Drdrl�mc f es SC+� [odrimtt DawTing I te/lman —(M t.s MACE4) _ <br /> RELMQUUMED 10Y � Speeia)lasnuetkam moumeab Saquaaa AxWyuanl Gonom m TYPa Key <br /> i 819 Soil m Ave.Sts 8 40 mI VOA <br /> amI <br /> Stgmavn3 5� St Swjwn ,Ca 93434 125 mi L�PE, 2 <br /> ,G4 SGL 91a pal�aoo 3m al Lm 3 <br /> PrintedN4wtio R " Qla a Rob8ow IliterFIDPL 4 <br /> _ ��S�a- 54tt m4 glass: 3 � <br /> Mum Y Finn p ��) I litergimt: 6 Cn <br /> _ — 0_�[ 216 Ah ems 7 <br />