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/ �JAS <br /> t <br /> VVPPP' <br /> CHAIN OF CUS (l� PL, Inc. <br /> RLC® �� 4203 W. Swift Avenue, Fresno, CA 93722 <br /> Phone: (209)275-2175 <br /> Fax: 209 275-4422 <br /> Pro <br /> j Name/Number Sampler(Print) Analysis Requested/Method Number Date Shipped: <br /> Z Scc ztiE' <br /> V.Fla.) Mlit-tA.E�L- C, Carrier. <br /> Purchase Order Number Sampler(Signatur }1 J Waybill No.: <br /> t <br /> Comments: C-/'7k <br /> Date Time Number of <br /> Sample Identification Cogected CoUeded Matrix containers ' 'J QV y L v <br /> A - .:�, -G •7� tc ,7riiS � � � 4t� AML VOA< <br /> i S G tti,L r 00 <br /> t 2.SC tY.L <br /> Y c R' -/ <br /> o � <br /> �. � a <br /> i R <br /> tMt 'i+4 02 o <br /> t ZsSomL- —I-)C.\.y <br /> 716L-1 <br /> Shuttle Temperature: Turnaround Requested: Sample Disposal- <br /> Standard(2-3 week) ❑ One week ❑ 2448 hour 10 Return to client Disposal by Lab(3o4syretention) <br /> Relinquished by sampler. Date Time RIWy: Relinqu' by: D b <br /> Relinquished by: bate Time Received by: Relinqu' by: //,Data /Time R iv b b <br /> Report to: �.�` r i Bill to: <br /> I✓7-7Z I�1 cc ` <br /> ICC; irJ1RL {�i1E►.�\�, `���'�T� '7cc <br /> (r <br /> Phone#: FAM <br /> White: Return to client vn'th reportrty_ Yellow..Laboratory.Copy Pink: Sampler y- <br /> 1�1��"� ..r/�� iE �'1•�� 'try4-,j l /6� y f-ei.CC'-.a• r`I C' �2157rr'! N° 3696 <br /> 1' C.o.C. <br /> i <br />