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�r-- � Cts. '�'j •�� '�: �� ,.__��, � -L,=•� ---=.a �-�a � _ <br /> 00 <br /> SPWorkorer No:SPL, Inc C- <br /> '(J2489 <br /> J2 n Q 9�AAnalysis Request &c Chain of Custody Record Y7769Z/,� <br /> page-7�'of <br /> Client Name: -` matrix bottle size Pres. Requested Analysis <br /> Address/Phone: <br /> ~ l� <br /> Client Contact: ��� ��� .�t. j , L-1C] O (Uv <br /> r j � N z <br /> Project Mame: `1-; 1 S ci � ti`,� '4 > N � x <br /> II Il II 11it <br /> Project Number: ' 0 � O ¢ > �, D N O <br /> pQ U O <br /> Project Location: `' O <br /> Invoice To: Il 11 O &D 00 x x v <br /> SAMPLE ID DATE TIME comp grab N C7 !!, CO 7- <br /> 5 -, <br /> �-1 z� D.�r� Vit, <br /> X x <br /> Client/Consultant Remarks: Laboratory remarks: Intact? ❑Y U N <br /> I Tem <br /> Special Reporting Requirements fax Results Raw Data ❑ Special Detection Limits(specify}; PM review(initial): <br /> Requested TAT <br /> Standard QC ❑ Level 3 QC Level 4 QC ❑ <br /> 24hr ❑ 72hr ❑ 1. linquislted by Sampler. dart u'ne 2. Recety <br /> ��l t`P�rl <br /> 48hr ❑ Standard 5. Relinquished by: date time eceived <br /> Outer ❑ 5. Relinquished by: date time 6.Received by Laboratory: <br /> ❑ 8880 Interchange Drive, Houston,TX 77054 (713) 660-0901 ❑ 500 Ambassador Caffery Parkway, Scott, LA 70583 (318) 237-4775 <br /> 459 Hughes Drive,Traverse City, MI 49684 (616) 947-5777 ❑ 1511 E. Qrangethorpe Avenue, Fullerton, CA 92631 (714) 447-6868 <br />