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t� Chain . Pt CASis Y,OWti'l.tr't'k: <br /> LaboratorleS,Incs Custody Form <br /> 57288 <br /> ' "7 �1 tTC1,(?tJtllt 11} <br /> He—1 7b: - • - . V ! 2 8 <br /> CClient: 11, 9' Project#: w Pae of <br /> Attn: f Project Nante-.XALYU, Comments: 0:11­ 16"J"iew <br /> Street Addreas: Al w1c- ro•ect Code: t� T 0 i <br /> Ci State Zip: tler s ,- 1 h <br /> Phone: v 1(1Fax -°a�� ( S ,h �i� t 1r,4 • c <br /> Sam le Matrix Are there any tests with holding times ss than. <br /> Email Address: e& r"' e�-, }'± P or equal to 48 hours? <br /> � � � °a' <br /> Yes No <br /> Submittal#; 3 <br /> �o <br /> • a- s s r, { a � �� „ w *Standard Turnaround=15 work days <br /> I. Ego <br /> • • • (n in M 0 3 Other � Dotes <br /> I <br /> Well ' 4—N-d 7 I15 lag i.3S.S X <br /> a (`<G fe 7 jJ51691 1 Q <br /> ' eIt 1* 7 15 X <br /> S Ve-II CYA-`*2. 7 1S /422. X K <br /> 7yrntte;d! {� 7^y 115169' 1 150 x <br /> i <br /> 1 1SA 145d <br /> a • <br /> ElSaa as above Report Drinldug Sample Disposal Special Reporting <br /> Ir I t]CwlP <br /> Waters on State Roan. Return 10 Client Ditix>sai by lab ❑ Archive: Months._______. ❑ ❑ ❑ Raw Data <br /> Client; r lZandfill 1. Rel ish By DaEe Time 1. Received By Date Time <br /> 11 ❑Yes No M t rl J{�J® ?I=�--g j <br /> Address:-! ————— we'll <br /> /' ' Send Copy to State of 2. eiinquished B} Date Time a ived Time <br /> City: ". State W i Zip CA, .� <br /> Attn: 4 %c. Yes ❑No 3. Relinquished By Date Time 3. Received By Date Time <br /> BC Laboratories,Inc.-4100 Atlas Ct.-Bakersfield,CA 93308-661.327.4911-Fax:661.327.1918-www.bclabs.com <br />