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Tit EMERY COMPANY � CHAIN Of CUSTODY <br /> PO <br /> ull Sen-Independent Testing laboratory &1dbhsW 1904 �"A,�yNAL,YSIS REOUE <br /> 781 East Washington Boulevard • Los Angeles California 90021 • (213)749 3411 • Fax (213)745 6372 DATE 7—J "5FJ PAGE Z OF <br /> P O Box 880550 Hunter s Point Shipyard Bldg 114 • San Francisco,California 94188 • (410)330 3000 • Fax (415)822 5864 <br /> 5427 East La Palma Avenue • Anaheim,California 92807 • (714)693 1026 • Fax (714)693 1034 FILE NO 2d,'e /LAB N0.3_14 _6( O <br /> CLIENT NAME ANALYSES REQUESTED' REMARKS n <br /> PROJECT NAME r r r PROJECT NO PO NO <br /> ADDRESS b C� <br /> CS a/ <br /> PROJECT MANAGER PHONE # 3 L-U <br /> SAMPLER NAME "' 1 � <br /> v� <br /> TAT(Analylical Turn Around Time) 0=Same Day; 1 -24 Hour, 2 a 48}tour, (Etc) <br /> c� <br /> CONTAINER TYPES B=Brass,G-Glass,P-Plastic,V-Voa Vial,0-Other <br /> SAMPLE DATE TIME MATRIX CONTAINER '00 SAMPLE CONDITION/ <br /> NO SAMPLED SAMPLED SAMPLE DESCRIPTION noTAT s COMMENTS <br /> wtinfn n uoat oaten TYPE <br /> e t ;'� <br /> �5 30 -,30;/z. ,,8 X X <br /> 20 -Zn 2, X I3 bC K <br /> 1 <br /> 5flelinquWwd <br /> By{ nd Pnnied Ns:% Received By{Spnature and Printed Name) Dale Time C SAMPLE DISPOSITION <br /> e 1 �`3 1 Samples relumed to client? YES <br /> 8 gnature end Punted Name{ ReF aY{Sgnatur0 Pnrded Name) �/�('C /�� b!e Time <br /> [�/l,¢N�a p6O 2 Samples will not be stored over 30 days,unless <br /> y{Signatuie and Punted Name) R9c9rv&dW(SgmhmiwWPrin66Namej Date Time additional storage time is requested <br /> 3 <br /> SPECIAL INSTRUCTIONS Storage time requested days <br /> By Date —_ <br /> DISTRIBUTION WHITE,YELLOW, PINK TO SEGO—GOLD TO CLIENT <br />