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IE> Laboratories,Inc. Chain of Custody Forel <br /> Repot To. y - ._ ■ <br /> Client: Uwr"c— $Avd vurr-�S Pro•ect#: 0 Dom.0A-- a of <br /> Attn: t�av 1a K 16, Project Name: fYl Cnd PQ-+ I I Comments: <br /> Street Address:-1`'b T�o n G4-• Global ID#:Sj'LS S3,0 7135(.6 I <br /> / I S Lr-�- Z <br /> City,State Zip: 4w,Vc�C 004 6 19 Sampler(s): ,j 16 k irk <br /> -"0 D ,Phone II <br /> Sample Matrix Are there any teats with holding times less than <br /> Email Address: A k it L l wI CnG,to- o ore 1 to 48 hours? <br /> 'i�Vork Order#• —dD 5 ,� <br /> 3 y � * Yes ❑ No <br /> e 3 Standard Turnaround=10 work days <br /> Samplu Description Date rime �4: ns <br /> Sampled - `4- <br /> �0 A C7 3 Other Notes� <br /> 1 19113 1300 <br /> S 61 18 113 17�d-� <br /> a ❑ Same as above EDF Required? ' <br /> Client: ❑Yes ❑NO 1. nquiade y Date Time 1.Mdy Ly Date Tame <br /> Address: ————— 1 3 NVO $�1 f <br /> Send Copy to State of gu' i35 ate Tim 2 Re el By Date Time <br /> City: State Zip CA?(EDT) kw <br /> ).1 <br /> 0 1 f-�•13 / <br /> Attn: El Yes El No 3. gmshed Date Time 3. Receiv Date Time <br /> BC Laboratories, Inc.-4100 Atlas Ct.-Bakersfield 93308-661.327.4911-Fax: 661.327.1918--www.belabs.com <br />