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7 67 tZY 6w6 VO <br /> 0 <br /> North State Environmental Anal it Laboratory 0 <br /> Chain of Custody/Pequest fnr Analysis , <br /> 90 South Spruce Avenue, Suite W, South San rrancisco, CA 94080 Lab Job No.: Pale of ( r") <br /> Phone: (650) 266-4563 Pax: (650) 266-4560 ���( �(� 3Zo 7 � <br /> Client: C.� c, Report to �-�t,r �, A S4 �e Phon �f 7�tf -7/ 7(� Turnaround Time 03 <br /> Mailin Address. BiNing to:6 � Fa O �"t' ero /1/01"rh L N <br /> c� t� ANG', <br /> PO#/Billing Reference:: Date: 1Z -3o - quo <br /> T <br /> GL64-(!� Sampler: <br /> Prptect/Site Address: UST Z'O 1, -147- 3 5*�/� 5C,19Ana`lysis <br /> k V M O7 /4o%/ Do,�,ol Reested <br /> Sample ID Sample Container Pres. $arttpling Comments/Hazards <br /> C Type No./Type Date I Time <br /> 7. <br /> f J©cc - �rC Z�3a�`f8 . <br /> Z C e� � S-o�C �2 ' • <br /> ......... <br /> Jr <br /> AU <br /> Ago <br /> tf71y <br /> Relinquishe y: �,� Date: 0 e: y' Received by: Lab Comments <br /> Relinquished by. Date: ime: Received by: <br /> Relinquished by IV\` Date: ime: geceived by: ~ <br />