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1680 ROGSW AVENUE CONDUCT ANALYSIS To DETECT LAA <br /> SAN JOSE,CALIFORNIA ORNIA 96112-1105 ALL ANALYSES MUST MEET SPECLFICAiIONS AND US I ECTION UMf fS a <br /> 1FAX(4021673-7771 SET BY CALIFORNIA JHS AND o <br /> TECH SERVICES,= PHONE(4010115734996 fl EPA ❑RWQC8 REGION <br /> a n LIA x' <br /> CHAIN OF CUSTODY 4 OTHER <br /> I7 LA o <br /> CLIENT u�i SPECIAL INSTRUCTIONS <br /> SITESend' Seem mvoice to I a v s <br /> 341 East Mam Street o %D � `� <br /> pn, CA u C14 <br /> j o o 0 -- II InmdeTd# 98995874 <br /> a 0 [y V a <br /> iu CA m o` t 9 Send report to Blame Tech Semces,,lRic <br /> MATR CONTAINERS 0 p b q .1 II ATTN <br /> o w w u Q � <br /> � _ <br /> "' <br /> SAMPLE I D DATE TIIUI>w { 3 ToTA!_ v <br /> AD MATION STATUS coNDITION LAA SAIIIgLE11 C„ <br /> • 2L <br /> -Tae4ec. <br /> L C"}� k Il C <br /> II <br /> s• ,A. <br /> II Ar Jr fT <br /> IS:1w <br /> RESULTS NEEDED II <br /> SAMPLING DATE TWE ' SAMPLING <br /> NO l,4 RTHAN <br /> COMPLETED J&: PERFORUED 9Y �G 1 ✓ <br /> RELEMED EY O 2 TfNLE , RECE[V!_D II <br /> jwj <br /> RELEASED EY DATE TIME RECEIVEDBy I` DR TII►4E <br /> RELEASED SY DATE TIMI+ RECEIVED BY II DATE TIME <br /> 0 <br /> ISHIIPPEL]VIA DATE SENT MESW CRQLER 0 II -� <br /> NEW <br /> II <br />