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vl IGL.I. VI loll VI vuatwuy I1C4vl u <br /> Lab,denLnce } Equiva Project Manager to be invoiced. t1AI `iVEIMSi ; qpi� <br /> Address <br /> c+iy slate z,a <br /> s=Nma, Karen Petryna 5 8 9 91 61 DATE 1 - 3•Z d o 3 <br /> [�o � PAGE �_ of f <br /> tNc couv end W n <br /> Blaine Tech Services BTSR 4315 Waterloo Road Stockton T0607700400 <br /> FDP 00.V4a&E TO Mup—"w O-V—r PHONE NO F;,V ON8ULTANT PA0jrCr No <br /> 1680 Rogers Avenue,San Jose,CA 95112 1,0C <br /> $01 o3-SN•Z <br /> MCA=C0wrACT#iwdmw w mw Raw dt Aubrey Cool 1707-933-2368Isonomatedcambrla-emr com sTsE <br /> Leon Gearhart euavLFleNA►�selwwsBllla.Y <br /> TezpMCNE VWX F40& <br /> 488-S73-0555 408-573-7771 iai h com :5'C wt-f- //CBC it's, <br /> TURNAROUND TIME(BUSINESS DAYS) <br /> 10 DAYS ❑ 5 DAYS❑ 7Z WJRS❑ 48 HOURS ❑ 24 HOURS❑ LESS THAN 24 HOURS REQUESTED ANALYSIS <br /> ❑ LA-FtWQCB REPORT FORMAT ❑ (IST AGENCY <br /> GGMS IATBE CONFIRMATION HIGHEST HIGHEST per BORING ALL FIELD NOTES <br /> SPECIAL INSTRUCTIONS OR NOTES CHECK BOX IF EDD IS to NEEDED Uv $ <br /> Contaln•rlPnservathro <br /> a� or PID Readings <br /> or Laboratory Nobs <br /> ` C CLAN MATRU, ip <br /> Field Sample Identification SAMPLING N g x TEMPERATURE ON RECEIPT C' <br /> adi r DATE TIME C(wTdm O N <br /> pl►w-3 113 7- xi -•p'3 <br /> h <br /> w 1 ) peen ThTw <br /> R dr f5ep+�Ius] hY ISIprn6n) TkTw <br /> Re!&quliifed bY'fta4++) er( ) Dale 77,7 <br /> 4 l0(�,p3 <br /> DISTRIBUTION YOM wM&W mwL Green 1)F,Ie Yellow and Rt b CJ" 1011M Ra*WW <br />