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s <br /> APPL, Inc. Phone: (559) 275 2175 CHAIN OF CUSTOORECORD <br /> 4203 W. Swift <br /> Fresno, CA 93722 Fax: (559) 275-4422 N° 17538 <br /> C.O.C. <br /> Report to: <br /> PLEASE PRINT Invoice to: PLEASE PRINT <br /> Company Name �N� Phone:-S/b- Company Name Cffo2MAIJ1Z � �r� Phone: <br /> Addrgss 1 SS G r{v� S-u r{t/ Address N124,j Vzj Ce <br /> Fax:S/0- j , - 7 7,�( Fax: <br /> / a <br /> Attn: /c:Nto Sa,✓yn/ � Attn: �6 berme -5- <br /> P ' <br /> Prqq' ct Name/Number Sample Print) Analysis Requested/Method Number Date Shipped: <br /> T^o r✓>h4m S f w�i`�T h� <br /> 0 Q.. / l 079 y- Carrier: <br /> Purchase Order Number Sampler(Signature) v Waybill No.: <br /> t <br /> t Comments: <br /> Sample Identification Location Date Time Matrix Number of 4 <br /> Collected Collected Containers 1 <br /> _ 001A)- S//lr_S.vS //�,tl 0P36) SoilTGY Sy <br /> 0.0W-.�sov-S w <br /> S.p w- 2.0 DV-�.0 S W �9( rx <br /> Ic I( 1 <br /> ,U ,2.ok- C.0 Sw l` U92� l /�Y �,1►..0 <br /> —S.ow- 73N- 12.o /2 1 t Oslo `1 t Y D� e2`f k•. - <br /> d )l3.30 <br /> Shuttle Temperature: Turnaround Requested: MUST CHECKN ,��f jar Sample Disposal: <br /> Standard(2-3 week) 04w ek 24-48 hour ❑ Return to client ❑ Disposal by Lab(3o-day,e�-1,-) <br /> Relinquished by sampler: Date Time ceivec(by .2 Relinquished by: Date Time Received by: <br /> elinquished by: Date Time eive by: Relinquished by: Date Time ceived bb <br /> White: Return to client with report Yellow:Laboratory Copy Pink:Sampler <br />