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PLETz <br /> fauratories,Inc, Chain of Cu Cody Form PL Ua�1) <br /> 47073�] 7 <br /> F <br /> ent "� Pro ect# ns Page epon 7") <br /> tn. Project Name nn,, Comments: <br /> E� <br /> Street Address Pro ect Code 9 / t'a to Fei to he ha k s tt is <br /> Ci State ZiL/ Sampler(s) .c f s < ge car `tis P] tit 11 <br /> Phone* 407 — Fax• g,.-9 _100 <br /> ,.-9 .-Q �/o s9.- D ' i ► t flo i5 m til tIII ti <br /> �V1 Sarnple Matrix Are there any tests with holding times less than <br /> Email Address y- ,ge id W v or equal to 48 hours' <br /> 11 Yes El No <br /> Submittal# Q 5— U 3-7 <br /> DescriptioTime <br /> , 3 c *Standard Turnaround=15 work days <br /> L` �b ^ oma t✓ <br /> SampledSampled n° Q 0 3 Other Notes <br /> w- <br /> -Sr I I oeze <br /> _(-P ev <br /> �ri <br /> i Same as above Report Drinking Sample Disposal Special Reporting <br /> ' - Waters on State Form° Return to Client ❑ Disposal by lap ❑ Archive Months________ ❑ QC E WIP ❑ Raw Data <br /> ClientYeS ❑ No 1 y Date Time It R ved*4 B Date Time <br /> Address — s ——— 6 6 - <br /> Send Copy to State of linquis ed By D�tT;me 2 rued By Date Trme <br /> City State Zip CA" v �W <br /> '��tn' El Yes ❑No 3 e guishe y Date w Time 3 Re ived By Date Time <br /> PO# e ,Q$ a' fS6 V!-310 <br /> BC Laboratories,Inc -4100 Atlas Ct -Bakersfield, CA 93308-6613 4911-Fax 66l 327 1918-www be com <br />