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%, rrar u=H I L- HNOLOGY, INC, FY`- I,.. <br /> ��- MAIN OF CUSTODY RECORD <br /> Analyticai L°.::: gyratory <br /> Phone:(9 16)362.8947 Gi.O.C. NO. 2 5 7 0 7 <br /> 13050 Fite Circle,#112 Sacramento,CA 95927 <br /> FAX:(916)362-0947 Page hof ` <br /> Company: � llVtlb xg� Phone: ,$ rj-bZfl� =_STAL Invoice Number: .—7;;r--., <br /> ANALYSIS REQUEST <br /> Protect Manager: f �� <br /> Report Address: FAX. REMARKS: Sampler's Name. <br /> Billing Name&Address: <br /> Protect Name: AlMOK ome <br /> ProJect/Job#: <br /> f� ►� �/ e-z poOw�T sTl_c <br /> Syq J .s�._ LpH <br /> oC <br /> Project Location: n <br /> TCLP <br /> Preservative TC!<P <br /> Sampling Contalner Used Total <br /> Matrix <br /> TAT <br /> wr _ <br /> ti o <br /> C Co <br /> �tl <br /> f N T t N <br /> 2 N O <br /> 0 W W z I N <br /> o x � w o Vi � <br /> CJ COco <br /> o CEJ <br /> P m a is <br /> ° o m U v <br /> m o U cc <br /> o w 2 =' a o_ uai = Ct7 U o <br /> Q N [0 W 0I Q O N coOO <br /> O QI W d Q [� 2 O O O O N N O Q mco W 7 N Y <br /> W E E .. z N neo eoo aWa °� _m` 'm 111 ' W <br /> y <br /> N0. SAMPLE ID Date Time O m J v o m - w w = `° `�° `�° `Q° `D `N° O a° •C `n 7 Ln m r� T <br /> 1 z �r ap r N O Z z O (A O m w W w Lu w W ° Z <br /> 55Z U s <br /> 2 <br /> V- <br /> 3 ! S <br /> s <br /> 7 <br /> a <br /> 9 <br /> 10 <br /> Relin sh by; R e <br /> 9.r <br /> y' Relinquished by: Received by: <br /> Date: r� �J Time: 0 1 Date: r] <br /> Time: Date: Time; <br /> PLEASE READ REVERSE SIDE FOR TERMS AND CONDITIONS Date; Time: <br />