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CV XIN OF CUSTODY RC '..-0®RD <br /> ;AMPLE (sig n a t u ); i4P/D1100' G�O.S/�S�dril7S <br /> 4191-E Power Inn Road,Sacramento,CA 95826 (916)452-2901 <br /> z 9 <br /> 6 0 . Fremont +Costa Mesa +Sacramento <br /> Phone SHIPPING INFORMATION: <br /> L A St R TA�Y: <br /> Shipper <br /> Address <br /> Date Shipped <br /> Service Used <br /> TURNAROUND TIME: <br /> ^- Airbill No. _ Cooler No. <br /> Attention: <br /> Phone No. Z~ <br /> Date Time <br /> Rel trashed 'y: laignatures? Received by: <br /> (signatures) <br /> Received f oratory by: I-" ILI <br /> o 0 <br /> µ ABORATORY SHOULD SIGN UPON RECEIPT IAND RESU TS COPY OF THIS 'vORNI WITH THE <br /> Date Analyses Sample Condition <br /> Sample Site Requsstea Upon Receipt <br /> No. Idontification Sampled .. 1 <br /> w 8�K r 'dLa <br /> 45� 4G1-b 6 <br /> k Mw� t� <br /> M4,au <br />