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V 6602 Owens Drive, Suite 100 <br /> Pleasanton,CA 94588 . CHAIN OF CUSTOMORM <br /> Main Line: (925)460-5300 <br /> Wx <br /> S U C , A T E S I H C . Facsimile: (9�2t5)463-2559 Turnaround 10 day _3 day 2-8 hr <br /> Project Name: Q,aKL%0,,0 0/.3,1 Client: c>•u�"CIS.S�� P+9'a,F,r5 Time: r7 day `2 day other <br /> Project Number: �5.f�2�o3.. Task: ( _ (working days) r 5 day ^24 hr <br /> Globall.D.: p p' <br /> Project Address: 5S Ai <br /> 20 0 k X00 <br /> Laboratory: L, rcm4151 o Contact: Z.5 N-130 <br /> Analyses Requested <br /> Lab Address/Phone: p Qupr <br /> ATC Project Manager: yjg0 m <br /> ATC PM Ph. No.. 925 225- Email:CI ISwG� �S atc-enviro,com 9 �s`,9 n i yi <br /> ATC Sampler: r Phone: 925 225- } `� o a '' , <br /> IA ~ o 4- <br /> O N to G � <br /> Sample Information Container Information o °f N s ��,- +� iq ci <br /> Field Pt.I.D. `� A N o in u u <br /> Matrix No. Type —' Check if sameas ° = O O v <br /> W o ; a 7 7 0 d <br /> ATC Sample ID Date Time sou w.w v.por p ' Sample I.D. <br /> F_ 11 Jgps 1•tCLr <br /> W-2. <br /> W. ,1s5 <br /> f2�o X <br /> Jaz <br /> W- 1 Oa° <br /> W- O a`b�O <br /> Additional Comments: i e saina <br /> /te T5 - <br /> F % W] <br /> EDF Format L2 IQ <br /> Relinquished By: - DatelTme: f ^t y 1 ,1 Received By: i �- DatelTime:!o y�� <br /> Relinquished By: DateMme'. Received By: % DatelTime: k54 is <br /> It <br /> Relinquished By: Daterrime: Received By: DatelTime: <br /> Sample Condition.Good? Yes I/No_ on Joe? Yes i/No Cooler Temp_�� C Tnansporlalion Method: Page O(T <br /> i <br /> White- Lab <br />