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HftIlV OF CUSTODV RECORD €3HITC: SHfrRWOODLAHS � <br /> P.O. BOX 937 <br /> Sherwood 1. 10, N. Lnndur Avenue HILM,IH, CA 95324 <br /> I-+,ll, u, allf f <br /> I-i111rinr, Galifnrrrin 95324 f0 <br /> (ow)f38'l�g`d88 Att�,tlon: "'N-: <br /> C O R P O R A T I O N FIAX (209) 8(17.2681 VICKI RUBIS209-667-5258 Page of 0) <br /> Aw LC <br /> kb Nvtbe< P.O, Pmloel New" �\ <br /> V11t.eGLl'Y WIyOLESALE DRUG p� <br /> Samoers:tSgnature) �— SherAr I+�iree <br /> 4 <br /> SAMPLE LOCATION DATE 'TIMI' NUMB811 YPESAMPLE + <br /> it6£HTIF1CATt4hif (fifTHlDhYoYFI) (hfOUFi+TuliN) OR <br /> GO NIAINE1#1.{ COMPOSITE) MATRIX REMARKS <br /> MW-1 9-x2-13 125 _w �u grab waters X <br /> Mini-S <br /> _.. ^1341 ...._ <br /> tn <br /> _. m <br /> CD <br /> _ ;y w <br /> Reiinq " ksy:(Sigrta,�re liulel llrlin llrrcaIVDJ By:(Signature) Datafnme !�'3L TURNAROUNDTIME <br /> w . It'.` <br /> Relinquished13N:(SignaRue) 114(1- I kih fit. F4d,,,d <br /> ( nalu 24 HOUR <br /> �048 HQlinquished By:(Signatu i11Nrl iil4d (Slgnalurej Da IY <br /> A <br /> diMMU710N: anginal-Acoo"aNea Bhylrtitenl I gri'Aly#I+ilryf[Ihol++Fwrd+ I+kik flggm llulltplar NOTE:Samples are d=srded 30 days after resuEts are repoeed unless other atrangernents are made. <br />