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Bach No a- - <br /> EN D R MENTAL Chain of Custody HYRCA PO-20$9 <br /> TEC H N OGiE S, i NC. Page , of .3 <br /> 2394 Manner Square Drive,Suite 2, Alameda,CA 94501 <br /> 510-521-2684(voice) 510-521-5078(fax) Date 7� �ZOOfl <br /> �� <br /> Analysis Request <br /> Lab Name TEG <br /> Address 11350 Monier Park Place b <br /> a � <br /> Rancho Cordova, CA 95742 <br /> dCo goo �+ O N O Cl a <br /> Telephone 916-853-8010 <br /> 06. w $ c <br /> w <br /> F u u a A y c u u <br /> Sapplers Si a res) <br /> > �— ° <br /> qq <br /> 0. ax ]F x a x O 1 z k m ° F <br /> Sample Number Matrix Location F F a XI p F > > > aQ 0. '� 0. F x a z <br /> L 0007 l� U �D �� <br /> 2 0007 113 D 4 s 11.1 <br /> 3 0007 4 1 6TO <br /> 4 /� ry <br /> s 000 <br /> 0007 <br /> 7 <br /> 8 <br /> 9 <br /> la Relinquished By 1 Relinquished By 2 Relinquished By 3 <br /> Pro3xt Nanx <br /> Project Information Sample Receipt Central CA Traction Co oud No of Containers <br /> i �c7 <br /> (rtne)(S,gnatute cfi e) t mt� (Tittx) <br /> Project Menages Chain of Custody Sea3a [St ) it ,- /lA ! i -p,4_,w„J -711 <br /> 7 1 <br /> Avaklan 1�YCX i"!a'`r' I (Date) <br /> (Date! <br /> (Punted )Name) ate {Punted Name) �J_ <br /> fob No Recd Good Cond,ttan/Cold (Punted Name) OM <br /> 007-346 <br /> Shipping ID No Conforms to Record <br /> (Company) (Company) (Company) <br /> 7, No Received By 1 Received By 2 Received By Laboratory} 3 <br /> Hand l X00 <br /> [rine)( t came)(St l 1� tom) <br /> { ,gnatun:) �f <br /> i Special Instructions/Comments <br /> G+lrrliGr�is ,+�t� t(Ot7 c ao fl ) <br /> {pont Name) ( (Punted Name) (Dau)(Pun Name) ,. O• L � 19 <br /> Standard Turn Around Time rp'A-I E- fT car T iY E <br /> [Company)ompany) ( 107) <br />