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"VI OHM L <br /> r l u800�roRr c �$00 —1 43 <br /> Co pany Name: W Phone N: ' <br /> FAX#: ° ❑ <br /> ❑ ❑ <br /> .ompany A cess: Site location: W x ❑ <br /> ❑ 0 ❑ ❑ ❑ _o <br /> a I cc � <br /> r ❑ o <br /> reject nagh : i Client Project ID: (#)�-7�,�7,., r ��0� o + e pj ° ° <br /> NAM L 1 `LJ e-tJ 1 o ❑ ° ❑ ❑ z z p Q ❑ <br /> attest th the proper field sampling Sa pier Name(Priv): t o ❑ rn 6 _ ❑ p -1, ° <br /> =edures were used during the collection `r ° ° ❑ m a a Cnn c A <br /> these sam les. ❑ o e Q 9 n g a R, a � � � � � ❑ <br /> Matrix Method Sampling o o Q ❑ <br /> Preserved a` ° ° ❑ o a <br /> Field GTEL ❑ z : 0 ° ❑ � ° <br /> Sample Lab # W � � raa ° ° ❑ �` � <br /> ID (Lab use only) 0TOM <br /> � o a o W � .� <br /> ' W a a d a a F- g O <br /> a ai a 9 z i z v I o a F m m = = 0 � °u7 w w w ua7 W o <br /> l <br /> i <br /> 1 <br /> A-1 I I ±H: I I <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> ,dofity(24 hr) ❑ GTEL Contact <br /> 'xpodlied(48 hr) ❑ QuotelContract N <br /> 7 Business Days ❑ Confirmation N <br /> -cher PON SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location: <br /> Business Den ❑ <br /> QA!QC LEVEL <br /> SLUE❑ CLP❑ OTHE FAX❑ Work Order# <br /> Reil Ished by Sampler: (Dole Time received by: <br /> C[�r t SIO DY Relin d y: D t Time Received by: <br /> k E C O R D Relinquished by, 715 <br /> to Time Received by Labor tory: <br /> .I <br /> � �Waybill # <br />