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S" = = = map M/ filin M <br /> on <br /> 1777 Bofelho Drive • Suite 260 • Walnut Creek.CA • 94596 • (415)946-0455 M&Qin ofTus?o%PrecM <br /> Job 4 2—3 l $. U`b Collection GC GC/MS Inorg Other Remarks <br /> Job Location 6e <br /> Sampler(signature) ,Z G,'� <br /> Prrnled name <br /> 2s y <br /> v b W nP,,� <br /> Lab Reporl Scapienlt <br /> 1 ` U �•Y) b C V lry`]•i'1 <br /> talaphone No (510) 946 0455Q- <br /> __ <br /> Receiving Lab Se L)O ILL C CL m"V (1) E ' _ s i Yt�{ p <br /> Address O a{ 5 W n o' vi <br /> Cc��f�1 �->F,� L� E 1 G f' <br /> r Wawalcr G.•cfru V 4 W w� [� <br /> Sample IDll Time 4-cen c r,n Volume u k i D- 1 1 E E I E Z <br /> SI_a ra 41on <br /> x !K 1 'C i I � SoC� <br /> xl1-1i LL se t <br /> SI 3 y _'x i _ i I i I E I t foo }_ <br /> 51-g3 f3-l36 OSS` <br /> = I <br /> S -if 110 n I X, I E i I �L — I � SAA <br /> I ; 11 � IE � IE � I Ii li <br /> Precautions Conc ]LO❑Med❑]Hi :Ship Via h,,,�,,[„ � ,,, Total Number o[Containers (� <br /> Sample Relinquished By Dale Time I Received By Date Time Reason for Transfer(List Shipping Bill Number) <br /> CM!, <br /> Company <br /> Company - - Company _ _ - <br /> t <br /> LABORATORY— 0 samples samples 0 Samples 0N of wnlarners tJ ConWiner lags O cooler seats <br /> {�Pleaso Comml a Intact at 4"C not leaking matches C of C W W. — matcn C of C — — Intact — — — — — — �. <br /> ' Lab sample aist an Signature— — — w <br /> Date — limo TSample �Isposltton Q Poturn to Slta Discard Q Hold days <br /> L — — — — — — — — — — — — — — — — — — 1 — — — — — — — — — — — — — — — — — zxff-nn <br />