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� rte <br /> �►IN of cusp■■wR ®DY RECORD Bill To <br /> Sherwood 8071 N Lander Avenue <br /> ,i P O Box 937 <br /> (� <br /> Labs <br /> Hilmar, California 95324 <br /> (209) 667-5258 Attention Phone e� of _L <br /> c D R P 0 R A T r 0 N FAX (209) 667-2581 S_SP�1 47 �' Page'--/ <br /> Job Number Project Name <br /> Samplers (Signature) PO Number �I <br /> SAMPLE SAMPLE NO <br /> NUMBER DATE TIME TYPE SAMPLE INFORMATION OF f REMARKS <br /> nom- CNTRS <br /> ! t --2 ,-LJJ kn- 1 i <br /> -3 �1.� P t d <br /> c3 - <br /> C-1 10-- <br /> cj oY �z <br /> /o f2. 'tfif f <br /> C� rr►r 1 a �o—t� <br /> cl?m f1 Ia �11 �1 d/f1-/J l <br /> �f <br /> Relinquished By (Signature) Date/Time Received By (Signature) Datefrime Ship Via <br /> X <br /> Retinquwshed By (Signature) Date/Time Received By (Signature) Datefrime <br /> TURNAROUND TIME Date <br /> Relinquished By (Signature) Date/Time R1Wd By Signature) DatelT1.im <br /> k - � 10 <br /> ❑24 HR D�Day U 10 Day <br /> DISTRIBUTION Original Accompanies Shipment Canary Copy Sherwood Pink Sampt NOTE Samples are discarded 36 days after results are reported unless other arrangements are made <br />