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ASSOCIATED LABOR.ATORIES <br /> 806 N. Batavia• Orange, CA 92868 CHAT OF CUSTOY RECORD <br /> (714) 771--6900 0 FAX: (714) 538-1209 Date Page of <br /> CLIENT <br /> PROJECT MA GER <br /> ADDRESS 2aQ ' Samples Intact Yes <br /> County Seals Intact Yes <br /> PHONE NUMB / C 4 Sample Ambient_ Coole'f-_--, Frozen <br /> PRO NAME SAMPLERS:( tur Same Day 24 Hr. <br /> �� r - Regulars 48 Hr. <br /> SAMPLE TYPE <br /> ..DATE.::.-_JIME,..-<-_ _ �... _ <br /> NO OF SUSP <br /> v -CNTNRS: CONTAM... T ..—s, , :..«'TESTS <br /> NUMBER DESCRIPTION <br /> WATER AIR SOLD REQUIRED <br /> �Ar <br /> uo - W <br /> K t yr—, <br /> 4 <br /> � _ <br /> - <br /> la Ile <br /> Rel he : i na ) i /Tim hereby authorize the performance of the above <br /> Re (StureRe d gnature) Date <br /> �� � � i ' indicated work. <br /> RelingVished by:(Signature) Receive by aboratory for analysis: Date/Time <br /> (Signature) <br /> Special instructions-. <br /> DISTRIBUTION:White with report.Yellow to AL, <br /> Pink to Courier <br />