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�mM m — m m m ism m mm m m <br /> �Tra aWga , Inc . CHAIN OF CUSTODY <br /> Ara Environrraente�! 5orvioae Cnmpe<�ray <br /> (514) 435-4991 OFFICE (510) 455-4995 FAX 1211 <br /> PROs. MGR tf,�, J� ANALYSIS REQUEST H <br /> u <br /> COMPANY Urea 1;%C,. T T T B O M p R v o o T S U <br /> ADDRESS _ 2458 ATTnafrang SttviBt <br /> P P P T & E UA 0 R o o A <br /> H H H E G T 0 O A A A A v o <br /> LwarmoM 24550 R C T N I+I <br /> G G D X A A A I I I L L r <br /> SAMPLER'S & L H R L C C I, g o <br /> SIGNATURE B E OH g 9 L E N <br /> PHONE No 3i0 455-499f T s N S D g w <br /> AA <br /> s Ev+t <br /> SAMPLE J.D.17. DATE TIME MATRIX X b.Zr D D a <br /> No 090130 <br /> F_ -- !! 141w1v 09 (s so>u. WATIs X t j <br /> Cas - k 6 <br /> 1:241411 01130 r.TXR No. 090131 1 <br /> r�1+�191 1000 saa ��� k X No. 0 911 i 7 r <br /> � - x`1.3 14119 1010 kTA,MTIIR2 X x NO- 090 133 <br /> F r <br /> loll <br /> �C No. 090134 1 r <br /> x No 09013 <br /> x No 09,113 6 4{ i <br /> `� � - S 1 ►}J��-l�,r i� CS Ss,� <br /> No. 090137 <br /> 1535 Sa►� p <br /> PROJECT INFORMATION. K N o• 09, <br /> 13 8 <br /> UI BY. i � /RELINQ11�i9HLD BY. N <br /> �L o ct.j � C r(� � �9ipwtur. isnatur. Straalvs. <br /> L&BORATORY INSTRUCTIONS/COMMENTS. �e eiat.d Nam. prliat.d x.m. <br /> Tura Around Time (Circle One) �L"�'"`�+' :t,,, fr c- C d v r <br /> same Day 84 48 ere C—P-117 <br /> 72 Kra orma� Tlme-.K L3 Data �a 6 f Time�Dwta Time `� Date r L <br /> Ss..�i.s b...At ow r[t- ca,.�lo► 1vr �� RE D HYD AECEIVFED HY: <br /> _ Cc RE CE D DY <br /> �E-ro-.'+sly 6 a i 1� �'� � 1�-}s� � �r✓[- ~?� � 1 4 %/ f-� -� � �'c 1 �J ¢�1/�7'a�., <br /> CC&,L4_6A- } ?r ee-ct ,FA 1C r P 14 w5 w{�5 prinL*d Names prlof+6 name Print" Na#mo <br /> T <br /> ao>i ICA TORr Nr� q g-{c �Compan� w <br /> Compraty �} company <br /> CITY PdcL� o Time / _ Date � 'lime- -) J �I _ l Time / <br /> Date ��� Date <br />