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CONCORD, CA 94520 ANDANALPSISREUU&b` " `.... "1.- r, <br /> t A t 510 685-7852 fP. I.I <br /> ttl•d !��%L <br /> +NC. 8001 423.7143 ::. I s) �, (•.,E �. <br /> Company Name* Phone N 671- 7-3197 <br /> ❑ TE3FAX R. ❑ <br /> Company Address- Site location: 91!0 � t ❑ ❑ © ❑ 0 ❑ <br /> 14A.19ft " Grfi <br /> Protect Manager' Client Protect ID. ( Q+ j Zr r 4 w ' �0 <br /> NAME ❑ ❑ ❑ ❑ ❑ 0 ❑ <br /> I attest that the roper field sampll ler Name ri <br /> _o ❑ <br /> procedures were used during the collection ` N ❑ y� �' ❑ o ❑ cc 0 0 0 a U ❑ <br /> ar these samples os <br /> ❑ O 0 n ; <br /> 7 <br /> Matrix ethod ampiing 0 ❑ ❑ ❑ a ❑ ❑ LL <br /> Field GTEL Preserved ❑ = a ❑co p a a ❑ ❑ ❑ \, <br /> Sample Lab # 11 <br /> w � $ � � Qs � � � � x <br /> ID Lab use only) c� a w ,� <br /> � D Iqi n m a t a a a a a <br /> mw WA � <br /> w Sb ' <br /> Co <br /> Ihw ISC <br /> tttd s ' <br /> w <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> y, 1�ps/1-��J 4 <br /> ♦/� 7 r <br /> PrWty(24 hr) ❑ QTEL Contact Sys /V/ `�/ I G7 A-5 <br /> Expedited(4e h" ❑ QuotalContrw N <br /> 7 Buslr+ese Days ❑ Confirmation N ' <br /> Other PO R SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot ll Storage Locatlon' <br /> Business D ❑ <br /> OA 1 QC LEVEL <br /> BLUE❑ CLP❑ OTHER FAX❑ Work Order i <br /> CwW70-00 ( <br /> Relinq by Sa a Date Time Received by' <br /> CUSTODY Rellnquishei b1F J D to Time Received by. <br /> RECORD Relinquished by Date Time Received by Laboratory: <br /> -711 y 00& Waybill 0 <br />