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/e 781 East Washington Blvd., CHAIN OF CUSTODY AND <br /> POSITIVE <br /> ANALYSIS REQUEST <br /> Los Angeles,CA 90021 DATE: PAGE _ _ <br /> .�..�. I LAB SERVICE (213)745-5312 FAX(213)745-6372 LOG BOOK NO� FILE NO. LAB NQ 1-q�OF �J <br /> CLIENT NAME: �, ���� �CsIF A� ANALYSES REQUESTED: AIRBILL NO: <br /> PROJECT NAME: ale r{�Tr 1 PROJECT NO. P.O.N0. Q COOLER TEMP:_U Z <br /> �� _ L? R PRESERVED: <br /> ADDRESS: j`JL�� FSP 4�J�`'.p.�^,.! �,A" t i11� �- r L_•�, 9��� � f <br /> QC REPORT <br /> PROJECT MANAGED ; `13� LEVEL: <br /> `t, u G� ., PHONE NO�� _ �� FAX NO: Q <br /> SAMPLER NAME: <br /> (s� r. wQ�k REMARKS: <br /> TAT Analytical Turn Around Time) 0=Same Day; 1 =24 Hour; 2=48 Hour; (Etc.) N=NORMAL <br /> CONTAINER TYPES: B=Brass,G=Glass,P=Plastic, V = VOA Vial,0=Other: <br /> SAMPLE DATE TIME MATRIX CONTAINER �L SAMPLE CONDITION/ <br /> NO. SAMPLED SAMPLED SAMPLE DESCRIPTION `� COMMENTS: <br /> WATER SOIL SLUDGE OTHER TAT , TYPE <br /> Is'40 Cz h1T wl_ <br /> 7/1 (y-2C" C't-1.:TC^_FMI/JU1q,* <br /> M r, I/ <br /> 9;i�ngw hed By(Sig e and Printed Nam R ve P Name) p ale: Trn <br /> 11 ' 9' i A �� 1. Samples returned to client? YES AMPLE DISPOSITION: <br /> NO <br /> nchnguished 8y(Signature and P anted N, e( Rrcewe Sign re and d Namel Da eTime: <br /> 2. Samples will not be stored over 30 days,unless <br /> Rehngwshed By(Signature and Printed Name) Received I Date: Time <br /> and Printed Name BY(Signature: additional storage time is requested. <br /> : <br /> SPECIAL INSTRUCTIONS: Y <br /> 3. Storage time requested: _._days <br /> By _ Date -- <br /> DISTRIBUTION:WHITE,YELLOW, PINK TO. LAB —GOLD TO CLIENT <br />