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CST E L 10500 UNIVERSITY CENTER DRIVE AND ANALYSIS REQUES�RD 24529 <br /> TAMPA, FL 33612 <br /> fNVIRONMfN1Al <br /> 1A60 (813) 979-9092 <br /> RAip RIES iNC ' . <br /> ompany Name ,/ Phone# .Slo) 67r- �13�s7 <br /> &rOQyXS wa'rtr TecJ'tano�� r Ax# 510 6�5 - `]1`�4 Cl Cl <br /> ompany Address Site location �/ w _ ❑ <br /> `to5� 17oc1- City tc� (lwy a�7/y� Ypoff^� ISI��{ m ❑ <br /> CA �Jsat> <br /> rotect Manager Client Project ID # c Ji ❑ # +CD <br /> + a 0 © 0 <br /> ``-- ✓ f c 090`74387 r . 6104 m � M � ¢ �? <br /> CYIt^t� oL1p NAME GO! Ph o ❑ ❑ ❑ ❑ z CO 0 0 ❑ rcr <br /> tLl <br /> attest that the proper field sampling Sampler Name (Punt) `o_ ❑ 65 M � : ❑ ❑ 8 E o ❑ J ❑ �} <br /> rocedures were used during the collection ❑ ; © ❑ ¢ ¢ " co � 0 s I� <br /> f these samples l�lGrk 1� 0-21 �N ❑ a cn ❑ a c o N Q tz ❑ a C ❑ IL J <br /> Method 2 cn o a ❑ N N ❑ ° o ❑ : <br /> Matrix Sampling 2 o o a s 0 0° � ❑ � 0 <br /> Preserved a- ❑ a a ❑ ❑ <br /> Field GTEL ❑ y 2 _ m - ❑ ❑ w w a a i� `d_w °N ❑ ❑ `C <br /> Sample Lab # w N S a � � ❑ ❑ ❑ a ❑ � � � � <br /> D CC cc(D rO T N x M u' g <br /> !D (Lab use only) Q W f7 �J <br /> � 5dO � R d 699 a 8 6 03 036 s� <br /> AS W F el p <br /> AF <br /> A !uF I 1TS,b <br /> 7, <br /> AS EFF <br /> ISS EFF 17 <br /> RS k`.FF I Y <br /> F SD <br /> 03 &a0 <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> minority(24 hr) ❑ GTEL Contact <br /> Expedited(48 hr) ❑ Ouote/Contract# <br /> 7 Business Days ❑ Confirmation# <br /> Dther As C ,liar W Po it SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> 3usiness Das ❑ 1 4°G <br /> QA 1 QC LEVEL cz <br /> 3LUE❑ CLP❑ OTHER FAX Work Order# <br /> Relinquished by Sampler Date Time Received by <br /> 416s 1 9 '°8 <br /> CUSTODY Relinquished by — Time— —Aeeewed-by— <br /> RECORD Relinquished by Date Time Received by Laboratory <br /> v NBI _ waybill # <br />