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R <br /> P a ra, o ' Chain of Custody <br /> A p � 13760 Magnolia v Chino C 710 �`�� Please print ixt pen Page of <br /> Tel: (909) 590-1828 Pax: (909) 590-1498 l�A�fJ <br /> Client: aIweb" rd �: <br /> Addmss: Cil .( � SEaIC: l� Zi rock: 7Wt'ic'e-- <br /> Bill to;� �, (�Tf �`- Ana.4ysi9 Itenia <br /> Piojecl Name/Code �J lob P.U. # ""th report <br /> I3roject Address - 3O APCL Quol.ation # ry -Lab copy <br /> - �� C <br /> Due Date: ❑regular rush: dayshours San3I3W 6y; ;� - -- --- — — -Airik=originator <br /> Field Sample 5tra►ple Date 'lime Sample Preser- # of , <br /> II) No. Dexcriptirsn Collected M.alrix vatioin Containers I Remarks <br /> i <br /> lr . <br /> 11 - <br /> - 4I <br /> i <br /> gCRequirement;. flegular; ❑QAfQGIltpart; ❑WIP; ❑Haw Data; ❑F:xtcnded}tawData ❑C1,Fi ❑ACU ❑AF'CI;;Ej,❑NFlN8A—(B,CcrD)i [1O0w (PleeseapecifY) <br /> II <br /> So-rnple. Disposal; ❑MLurn.,Z()ieposnl by APCL ❑lSnld for _days alter receiving dale. If not apvcifletfr s!' plea will be discarded 45 drays alter maniples are received. <br /> Sample.Conditions: ❑Intact; ❑Broken. Cooltr Sea]: ❑lntact; []Broken; ❑ None . Tag# ! Temperature; ❑ boom ❑Cold( 'C), <br /> li <br /> R,el'lnquiulied by z,�--- =ll.e�"Time y � R,eceivcc by Date/Time evr-�-5-11 IJLP) <br /> Relinquished by Datr;/`iirne Received by i Date/Time <br /> APCL USE ONLY Service <br /> Client*understand that all terlfta dcscribed in the propoxsit, quotation* for thin project, and/or Lhe general terms provided in the curreet APCL price schedules will be followed. APCL resttves Che right <br /> to terminate its service or withhold delivery of ao,y repoi•ls,IC in APCL's sole diacrttion the tenni of the project have bccn bmk-fl, <br /> ._.-. .. . .�. .., n_. .w +•.a aa.{_tll•arUS T.DATA."13tCn A IN.RAOT.Toa Pp.:iCUS'r.DATA,LAA]Cr1A1Na.T8A <br />