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r■� Illy = M r r Ir mm M " M M M s MAm 11 A1111111111h <br /> Ili <br /> TEG Nort rn California Inc. Chain of Cus y Record <br /> I <br /> 11350 Monier Park Place j, Ph: 916.853.8010 Page: _� of <br /> Rancho Cordova, CA 95742 l=ax: 916.853.8020 <br /> Client: Vo'ke�-i t Ay'romaw _ Project Manager: C)G-v j3 frko <br /> Address: (w 05- l`�rr+�w TEG Project#: 10 ZI � Client Project#: ,-z", 1 ? - <br /> Rrs�.c.� C.ytC <br /> CIA I D Location: �=rare�eY T'nti;.�c ►.. 1 tz. � f <br /> Phone: so °l -Cj RS-Sb Fax: -11 it-17Y" Collectors e 0,7t, j 4 Date of Collection: !S 12-1 (aZ <br /> N <br /> �•'�� a�o`P 011 5��1 �°�° ;n <br /> 1 -6 <br /> VV w <br /> Sample Container 93 � � � �ry64�� � 10-^h 10��h <br /> Sample Designation Date Time Matrix Type AQP AQP AQP wQP AQP �ti6a hp+�Q� �Q� �Q� �� Field Notes <br /> i8�]T NWS 5 t 16 st.>i L G t+ss 1 , X <br /> 8o'T NES k <br /> o-r e- K k <br /> BOT E k k x <br /> Bo'r W5 x Y x <br /> go T- w .5-S X >< Y <br /> To P Ir s x x x <br /> Qw 15S X X <br /> 7D P X <br /> SDP S X <br /> To P w S k k <br /> P IVn15 X <br /> t3o T w � k x k <br /> ~rod E Ns n K <br /> BST SNS X <br /> Relinquished by: - ` Date 1 Time Re i ed bDel 'fil 1431ate 1 Time Sample Receipt: Remarks. <br /> Relinquished Date 1 Time RedeiveWby Dale 1 Time Good Condition? <br /> ' Cold? <br /> Relinquished by: Date 1 Time Received by Dale 1 Time Seals Intact? <br /> I <br /> i <br /> Total Number of Containers <br /> Distribution: White-Lab,Yellow-File,Pink li°nginator Sample disposal Instructions: _TEG disposal @$4.00 ea. _,,,_Return to client —Pickup <br /> II <br />