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sir see ■ate stiiti i11110111P11ti <br /> s <br /> CAST* ANALYTICAL LABORATORY <br /> I-4-8 �2A CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No 2079 <br /> Mailing Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE I OF <br /> Phone (209) 384-2930 - Fax (209) 384-1507 <br /> Customer h [ REQUESTED ANALYSES Method of Shipment <br /> Address <br /> City/State/ZIP ,� -= Cf�' OV�i'�r hf <br /> Phone I FAX y— s R Nates <br /> Pro) # 1 P 0 # � "' " w w <br /> Report Attentionk-ri a,)• g 9 r X o ; <br /> Sampler Signature- <br /> Printed p <br /> Z <br /> Lab 109 SAMPLE ID DATE TIME DESCRIPTION&OCATION OBSERVATION'LULU26 2 p 1 � <br /> MW I <br /> 26282 <br /> - W3 <br /> ,_ <br /> + _ mt� S �- 26264 <br /> 't'o3Nya'y ' F+ X <br /> 1 I <br /> w-� o 26285 I <br /> I <br /> x 26266 <br /> 26267 <br /> - ' <br /> R <br /> inted Name t] to Time <br /> Company Name Total number oa submltled to <br /> Relinquished byf t Note All special requests(e g quids <br /> Received by L *� !� ! j{),� tum times)must be cleared through <br /> authorized laboratory personnel r, <br /> Relinquished by <br /> 4 <br /> Received by <br /> Relinquished by RESULTS DUE <br /> Received by' VERBAL Ll WRI N <br />