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/FIS �� �, �� 3 <br /> ANALYTICAL 7.0 Olive Drive,Suite D Lab:916-297.4800r� �7 <br /> LLC Davis,CA 95616 Fax:916.297.4808 Page <br /> Project Manager: Phone No.: Chain-of-Custody Record and nalysis Request <br /> C7160— <br /> Company/Address: FAX No.: For Lab <br /> Q Ga w►P L'r. . �/6 Analysis Request Use Only <br /> S�3�9' `� <br /> d — WE.T.(X) <br /> Pro e umber: o.: Project Name: co <br /> r��o9 i 3 <br /> TOTAL(X) Y <br /> Project Location: am Sig ature: 0 3 <br /> C3 <br /> Co t <br /> G w co o <br /> Container e o <br /> Sampling (Type/Amount) P Matrix 00 — " N N z L <br /> CD m <br /> v <br /> ti �• O �+ co <br /> O N =m o a a N N N <br /> w 16 i 1 2 N L <br /> rn O (rL 0 O CD <br /> co Co C r- r a <br /> (C (G O c0 0 c0 N V - <br /> Sample d W E o z I w S z d d d d d m U t <br /> Designation Date Time U _ = - zz 3 m m r r w w w w w v U <br /> S-I S--T� S <br /> -X <br /> t - <br /> Reli she by: Date Time Received by: Remarks: ri�T'�. <br /> �i <br /> ui ed by: Date Time Received by: Email ad re�S - <br /> Coylla,61 <br /> NIX,& �nA <br /> Relinquished by: Date Time I , Rec ed bb Labo tory: / Bill to: <br /> COC.fi5 <br /> Distribution: White-Lab. Yellow-FiAe, Pink-Originator <br />