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/ ASSOCIATED LABORATORIES <br /> l � CH IN OF CUSTODY REC RD <br /> 806 N. Batavia Orange, CA 92868 <br /> (714) 771-6900• FAX: (714) 538-1209 Date Page of <br /> CLIENT <br /> ` PROJECT MA ER <br /> ADDRESS �1 L/ C _ Samples Intact Yes No <br /> I v County Seats Intact Yes No <br /> C l PHONE NUMBER , Sample Ambient— Cooled— Frozen— <br /> PA 0 J E <br /> rozen_PAOJE N ME SA LERS:( g 11tu ,r _ Same Day 24 Hr. <br /> r r Regular 48 Hr. <br /> v l SAMPLE TYPE NO.OF SUSP. <br /> BATE - . ;..riME._._ T..�>_� __ ....TESTS <br /> NUMBER DESCRIPTION WATER AIR SOLID CN�nsRs. COTAM. REQUIRED <br /> lipe 5Y� t <br /> : <br /> L'Reflnqu hed by:I ture) Received b �(Sig at e) ate/Time � <br /> cl 'I hereby authorize the performance of the above <br /> 4 , y indicated work <br /> fielinq shed by:(Signature) Receive by Laboratory for analysis: Date/Time <br /> (Signature) <br /> Special instructions: <br /> DISTRIBUTION:White with report:Yellow to At- <br /> Pink to Courier <br />