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SIERRA LABORATORIES CHAIN OF CUST Y RECORD Date � Page fTEL 714.758.9988 _L <br /> FAX 714 758 • 9692 L —oc)7 <br /> 1525 Endeavour Place• Suite D• Anaheim,CA • 92801 Lob Project No. <br /> Client �(41—��}}1(l[1��Y11���1 11 [ Client Prof NumberfProj Name Analyses Requested <br /> Client Address '1Z3 y K 1 G �%� �l ll �� 1 ,4 E y <br /> acti1►� ,CA GS�� ! <br /> �.. Turn Around Time Immediate Attention x <br /> <m 6 Y uJ <br /> Requesled y m Z c <br /> Rush 2448 hours 3 r <br /> a <br /> CBtet Tel No. q 6-05;-Z-mo r�f Rush 7296 hours <br /> Chen[Fax Na o <br /> Client Prol M1tgr fit' 2YFtZLc� a� t�u�l ❑ [Noble 5 0 � I � o °� y S <br /> Container N0.of <br /> Client Sam le No Date Time Maim Preservatives Type Cont-ifners �l P Comments <br /> �{4u hot 2 Lb"I" ru ed �C,1 Yoe y X4V)etc�()Mw- <br /> W)- C It30 Piv) 0L� VCA X (mvi�l�Yl � 1 <br /> NJ one, ,\1x1/ 4 X <br /> 45 pill RL,� <br /> �No3 Plus r. i IX <br /> ISOr]'c A1O1 X <br /> 0 <br /> Sampler Signature Shipped iia Tata]Number of Containers Sam pit Disposal <br /> 'm ]/, ,f1 M)I t l ' Submitted to Laboratory ❑ Return to Client <br /> ompan' 1�l�Vl rUrl/1! (Cerrkr/Warhlll No b <br /> The dehrery orsamptes and the signature on this chain of custody toric co Unitas <br /> Relinquished B 'i Date Received B Date 1 aoihar, to perform the analysesspeclfied above under S[ERR A a Terms and E.aL Disposal <br /> P Date,0C) <br /> �`�� !� <br /> Time Conditions,unless otherwise agreed upon in writing bet.."SIERRA and CLIENT <br /> r 1/ 1Z/I Ti• Cam h� Time a 't <br /> Com an Archne_mos <br /> 7 <br /> Retlnqunhed By Dale Received By Datt Total Number of Containers Other _ <br /> Company Time Company Time Received by Laboratory <br /> FOR LABORATORY USE ONLY-&ample RteelptCondilions. <br /> a <br /> AehnquishM 8y Date Received By bate Q Chlbed � Appropriate Sam pk Container <br /> Com an Time Company Tlme intact Ap(NpprtattPreseyvgElves <br /> Special Instructions <br /> SampteSeats � Olptr <br /> Properlyt,abtkd 0 (Hips <br />�4 _. Rev 071693 DISTRIBUTION While To Accompany SampK Yellow Leboratory Copy Pink Field Persaonel Copy <br />