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A L Y T I C A L 1999090809 MA 09/27/1199 <br /> � ORATORIESAnalyses Request <br /> BSK S �I Al Standard c, <br /> �'re-L{�g In ID# 927004 Chain of Custody <br /> I414 St.liusiauti Street fresiuy,CA 93706-16233 <br /> (i19) j97-2888 800 877 8J1p (5591 mX 485-(915 ReyiftstedAnalyses <br /> I SII iiw M&V7a l: <br /> Client Plain Ill Ane�nlu�� 1y/L�1 ^� 1 >� <br /> 2E +� � pt41 <br /> T`f ! G i7C� LF� f <br /> Ad <br /> t�18s3 -9z�3 <br /> dreiia V <br /> III 3,u,tt 43r PO f A\f <br /> city suit zip Q / -li 0 ` p 178 14 �3 -'JZ 9,7 <br /> 40 <br /> ashy u, <br /> IAB use only <br /> Sampled by <br /> Date Time (o(nnit.nl or �. <br /> si;pk type fom Sampled Sampled Sall DL%LT1pli011/lA)4Lallon till(llpl(Udl <br /> MM` <br /> TrA <br /> W <br /> • z � a =a� W-DAM . �sE �� ,� <br /> All 6r - Mv✓- A /'jx <br /> ! :za til• - M V*/- Z W <br /> L` - :oo W - 7Z - \A/ - 1 <br /> N <br /> Mairix Type.L Liquid 5 Solid G Gas <br /> Adoat Strvlttti y Adod Stn iti AuihuyType of Hazards Associated with Samples Rush Priority ZUay <br /> Payment Received with Delivery <br /> I 1 Q( Data pa,kag, Ltvti 11 Ill or 1V(tirtlt o1w) Dale—� Amount $� <br /> 11 Formal(hail,of s tt..tiitty Check J_ —Initials _ <br /> (gigrl tlurt) Receipt J.� <br /> Slgnaturc Prim IVaox <br /> Rcceri Relinq : (otupany <br /> Dale Time <br /> Ret t Re nqu �• �/�-l� Ste- <br /> ReccWcB! <br /> Uunqull by <br /> Acochmd for <br /> n 30 <br /> Ir n <br /> hen Inv d <br /> Notice Payment per <br /> se month <br /> per an m BSK nplw.dales shall he entitled 1 ed pseca er on deur ant accounts coals of o(lec bons balances <br /> qq alirxnevisilaac�ur�i„i ueni balances are subiecl to mol lhly aerv�celie bilkng chaogey and lnleresl rat <br /> cl.laied a1 i IM Pll nY'^ <br /> or otherwise Th person slgnl for lha[',,I'll nrnnana ovnrneel .,.L� ^ ._r_._ - <br />