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CaI <br /> 2795 Second Street, Suite 300 science <br /> KOIFFDavis,CA 95818 7440 Lincoln Way <br /> Lab: 530.297.4800 Garden Grove, CA 92841-1427 � 3 <br /> Analytical LLC Fax: 530.297.4808 714-895-5494 COC No. 71 Pae 1 of 1 <br /> Project Contact(Hardcopy or PDF to): EDF Report? NO Chain-of-Custody Record and Analysis Request <br /> Troy Tur en <br /> Company/Address: Recommended but not mandatory to compete this flection. <br /> Kiff Analytical Sampling Company Log Code: Analysis Request TAT <br /> _ Phone No.: FAX No.: Global ID: <br /> 530-297-4800 530-297-4808 <br /> Project plumber: P.O.No.: Deliverables to(Email Address): <br /> 01-14 73710 inbox kiffanai 'cai.com LU o <br /> Project Name: Container!Preservative Matrix m <br /> a <br /> Celifomia Islamic Center,Lodi O °0 <br /> Project Address: Sam lin <br /> L <br /> U. <br /> Sample a <br /> Designation ¢ ro m <br /> 9 Date Time o <br /> _ CIC-01,02,03,04 07/12/10107:30 3 X I I X I I I X <br /> CIC-05,06,07 07/12/10 07:35 3 X X X <br /> X, , <br /> is Date Time Received by: Remarks: <br /> r n Cq 71210 (goo <br /> by: Date Time Received by: <br /> Relinquished by. D to Time Rived b Lab ratory: Bill to: <br /> © ltd t Accounts Payable <br />