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w <br /> Date C1 THE TWINING LABORATORIES, INC. Page-of- <br /> 2527 <br /> age of2527 Fresno Street, Fresno, CA 93721 <br /> I- Z (209) 268-7021 <br /> Chain-of-Custody and Analysis Request Record <br /> Protect Name { tett No k �' Project Manager t �G c �, Pro i 9 <br /> Sampler IMG L Z'i.n°, Company k, 0 Phone Del By C- r. z+r r( <br /> SEND REPORT TO SAMPLING LOCATION 0 ILLING ( Ircle One) EXPECTED TURNAROUND <br /> 5 <br /> Company V_. 1 ( NC_ 9 U,V, 4 nL. ,o Company ;i V\1 LAS fv�"t}-,(1N �31N,. Rush <br /> Address Z 1 g U F►�fQ v �'� ��- c l�'�{- Address 2 I ' G t, 1 v 'vi e Routine <br /> r <br /> r_ )e ; Vu -, n � . 9 �} (Specify Time <br /> t YY\ C_ ,� �Q(o r� <br /> Contact Name _✓� >r, �f�v C �, r�C��c��_�^ __ Contact Name <br /> Phone 1, 1 7 C G S-S _ Phone - { Q <br /> COPIES TO <br /> Analysis Request ' <br /> Number of <br /> Lab' Client Sample Sample Date/Time �J Containers <br /> ID # ID # Description Sampled Analysis Requested Per Sample <br /> L) Ilk) <br /> a <br /> "um a/ G� t1GU� Gt <br /> 'Lab use only <br /> krkqumhed Affiliation DatelTime Rec6-jvea By Affiliation Dafe/Time { <br /> S <br /> 4 <br /> �i��Received By Affiliation DatefTime Received in Lab By Affiliation DatefTime <br />