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t>• ta»tall■ »• tai♦ tata»� IIIIIIIII� ItIIIIIIIit tttttw■1 ittA�l■It rttttt� �� �� �� � <br /> CHAIN Of CUSTODY <br /> TIVE 781 East Washington Blvd, A ALYSIS REG UES <br /> 0 <br /> Las Angeles,CA 90021 DATE PAGE OF <br /> SERVICE (213)745-5312 FAX(213)745-6372 LOO BOOK NO FILE NO LAB NO ' <br /> CLIENT NAME ANALYSES REQUESTED, AIRB{LL <br /> COOLER TEMP:-3162F <br /> PROJECT DAME PPOJECT NO PO NO <br /> 3 PRESERVED:_ <br /> ADDRESS <br /> M OC REPORT <br /> PROJECT MANAGER HONE NO:` NO LEVEL: <br /> SAMPLER NAME -- REMARKS: <br /> A ` �z L4m <br /> i^ b <br /> TAT(Analytical Tum Around Time) 0-Some Day, 1 ■24 Hour; 2.48 Hour; (Etc,) <br /> CONTAINER TYPES; B•Brass,Q-Glass,P-Plastic, Vial,0■Other. -` <br /> SAMPLE DATE 11 TIMEASI SAMPLE CONDITION/ <br /> NO, SAMPLED -SAMPLED SAMPLE DESCRIPTION wATP � M OMM TAT TVPIC ! COMMENTS: <br /> la % , r <br /> r r y <br /> * ; I <br /> .4 <br /> f <br /> 1 yr <br /> I < <br /> i <br /> S <br /> I <br /> t111 <br /> Y <br /> f <br /> ng ned Sgnalure and Ponies N Received a [Signature and Pnnted Name) ale T1me SAMPLE DISPOSITION <br /> 1 Samples returned to clrentl YES 0 <br /> ws ed By r n Nam e S gnatuna and P ted N. Time <br /> D". 2 Samples will not be stored over 30 days,unless <br /> Ada <br /> A11 <br /> ellnqumNd 9y ISVr%ature and Printed Namay <br /> Recel ey [Signature noted Name[ � T,� additional storage time is requested <br /> 3 3 Storage time requested days <br /> S CIAL INSTRurTIONS <br /> By Date <br /> � I as rnav "� <br />