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Laboratories,Nice ChainCustody1 pIBMQUOUID: <br /> Report Ta. e . s <br /> Client: P,-.v As Lic Project#: �` Page--j—of_j <br /> Attn: 1 r-" Project Name*rcC rntar Comments: <br /> V- WCA <br /> Street Address: t O �r; lobal ID#: 9 s f, t <br /> Cit State Zip: <br /> � sampler(s): <br /> i�fr <br /> An tae <br /> e anytests <br /> i holding times less thani�nZn <br /> or equal to 48 hours?Same Matrix <br /> Email Addressg <br /> co <br /> 6 T <br /> Work Order#: - - o x ❑ Yes No <br /> 3 W <br /> 3 *Standard Turnaround=10 work days <br /> Other Notes vi i7 C7 3 <br /> Advor <br /> dZ7er nuc __ <br /> I �' /' �-�- P 73,x' � <br /> FB L <br /> W )1 :0 0903' A <br /> 4 G 0151-7 <br /> I 111! C y, -# 1 1093Z <br /> MeII"i LY "2- d-17 <br /> g Weis <br /> Report Driu&ing Sample Disposal Special Reporting <br /> F-1R <br /> Same as above ❑ r&$ QC ❑ EDF Raw Data <br /> /�� f Waters on State Form. Return to Client Disposal by lab ❑ Archive: Months <br /> Client: l }f 1 1. Relingnished By Dat Time 1. Received By Date Time <br /> ❑Yes (�NO <br /> Address: 'qq9 __ --—— ------- .. ro fv o ��d F _ I rallmo% 11000 <br /> Send Copy to State of 2• Relinquished By _ Date I Time 2. Received By Date Time <br /> City: „'eState dip CA? — I _ tatt,�c�I T <br /> Attn: Cq [ Yes —1 No 3- Relinquished By Date Time 3. Received By Date Time <br /> PO#: <br /> BC Laboratories,Inc.—4100.Atlas Ct.—Bakersfield,CA 93308—661.327.4911—Fax:661.327.1918—www.bclabs.com <br />