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=Labo 'atorms, ne. Chain'dA Custod Form <br />Y <br />A, <br />Page or—L-L.- <br /># <br />Project <br />Project Name: e Comments: <br />Global. ID #: <br />Lreeth dress <br />H <br />(S) <br />'ity"State, Zip 4P VCP <br />`holl enz, .2�;d <br />Sam <br />le Adm <br />A, Ilere any tests with holding Linies 1(%S than <br />or equal to 48 huiu-s? <br />:MgH Ad Ur . ....... <br />AJ <br />--F-1 Yes No <br />Vork Order #:0 <br />Standard Turnaround = 10 work days <br />Notes <br />Cr <br />�5 <br />09 <br />Other <br />b <br />411 <br />-e <br />z1 <br />u.) <br />7 <br />K <br />A V <br />A <br />N <br />% <br />Isposal <br />Same as above ED Ruiuilw? <br />Special R -pot -ting <br />E] QC 0 EDO Raw Data <br />R—Ul to Client Dispusul by lab <br />lient: "'IQ2 L jhl4isquls Date <br />ILI— No <br />Ti me <br />1. Receiv ed By Dat, Time <br />Yes <br />'kaiz:7., <br />— — — — — — <br />1f <br />Send Copy to Siatt 0 <br />B Date Time <br />2. 1 Ili q ul S Aed Y <br />2. Received By <br />Date <br />Time <br />ity: Z ip <br />CA? EYE) <br />f .A <br />My'ec 0No <br />isDate Time <br />3. R01lqu-hLA By <br />3. Receive(! By,, <br />Date <br />Time <br />D#- <br />Nvww.bclabs.com <br />nc Laboratories, Inc. — 4100 Atlas Ct. — Bakersfield, CA 93308 — 661327.4911 — Fax: 661.327.1918 <br />