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SPS,Workorder N . J-'293955 <br /> 79SPI., Inc. iin MR <br /> Analysis Request&Chain of Custody Record page of <br /> Client Name: 4 T(- Aiio,644ff y, matrix bottle size pres. ReCtlleStetl Analysis <br /> Address: Lom Pedw Avc n✓L V ;261 if <br /> �1 <br /> Citv o d! State (eq Zip , d 0 <br /> PhonelFax: - 7g-7 aj ;�69-S�9 a?�� o "11 II4� <br /> II � � <br /> Client Contact: +� Email: 0 n 14 I L O o E- d X <br /> p as.� oN Zo <br /> mD = 1 <br /> Project Nae/No.: 0'101 6 �, 604 0 Q i u o = Q <br /> cv�C <br /> Site Name: e Yo�tJl�javt rwJ L+C Un y II w <br /> Site Location: Vn4 1/ r' <br /> Invoice To: /4TC 1,40df Ph: .5f4aa-C <br /> SAMPLE ID DATE TIME comp grab of h I oo !h r;� <br /> /v1 w-� 0 3 0 Y10 11 P S -3 a x <br /> 0 3 0Yl a 1 1 3 -7 w <br /> w-s 0 30yl0 da L4) 3 a x <br /> tu- 030YIo 350 W A 3 a X <br /> /Vj L" 3 a x x <br /> Client/Consultant Remarks: ) I Laboratory remarks: Intact? Y N <br /> Tem 0 Y N <br /> P <br /> Requested TAT Special Reporting Requirements Results: Fax❑ Email a PDF O Special Detection Limits(specify): PM&view (initial): <br /> ❑ 1 Business Day ❑ Contract Standard C Level 3 QC❑ TX TRRP❑ LA RECAP❑ <br /> ❑ 2 Business DaysStandard 1.Re' uis by SamCj date time 2.Received by: <br /> a 3aylo 15-3 J"❑ 3 Business Days 3.Relinquis d by: date time 4.Received by: <br /> ❑ Other 5.Relinquished by: d t ti - ce' a a <br /> l y <br /> Rush TAT requires prior notice <br /> ❑ 8880 Interchange Drive ❑ 500 Ambassador affery Parkway ❑ 459 Hughes Drive <br /> Houston, TX 77054 (713) 660-0901 Scott, LA 70583 (337) 237-4775 Traverse City, MI 49686 (231) 947-5777 <br />