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= = M = = M M M M M = M M M M = M = M <br /> ------------I <br /> 1>1TME COMPI E <br /> Laboratories,Inc. Chain of Custody Form <br /> Repoe To: A 0 <br /> Project#: P!Le-A— of-A— <br /> Attn: Ef-61 FLALkn�. Project Narne:Ntl CC V- Comments: <br /> Street Address:%V's6 Global ID#: IVO <br /> City,State,Zip:SJ, kt,�,IUD )_39&A Sampler(s): Xe_sl;P_ <br /> , A <br /> Phone: A q,39 q tit Fax:a 9a,9'677 frin Fo-v%-.t k 2- <br /> Sample Matrix Are there any tests with holding times less than <br /> z;-'- or equal to 49 hours? <br /> Email Address:C-TOIAIrl &Ci-tc 9�'Urr........... C6 <br /> yes DK No <br /> Work Order tP: 00 <br /> 00 *Standard Turnaround=10 workdays <br /> I NMI 0 <br /> to 0 inOther Notes <br /> X UT <br /> W,61 0 <br /> 2- L4 <br /> 3 - L-A t 1 1 <br /> -A We_�\ . r-lil CIA 4_1 L-L- 13M...... <br /> IF (4P, <br /> -7 <br /> I y4nor Fav cc+ . <br /> _9 J W109 hi A <br /> R BUT 10r,4 <br /> ❑ <br /> Special Reporting <br /> Same as above Report Drinking sample Disposal EJ ac E] EDF E] Raw Data <br /> Waters on State Form? 11 Return to Client DlspoW by tab ❑ Archive: Months— <br /> F]Yes 0 No 1. Relinquished By Date <br /> Time 1. Received By Date Time Address: 7JA [I 7s5 r-eJ eX 3L0,1.0.549902i 71240711-156 <br /> Send Copy to State of 2. Relinquished By Date lime 2. Received By Date Time <br /> City mckkkie-Coh— State C-A Zip "5336 CA? --I <br /> 2c{ jUfs <br /> Attn: Yes n No 3. Relinquished By Dale Time 3. Received By Date <br /> Time <br /> PO#.- I — <br /> BC Laboratories,Inc.—4100 Atlas Ct.—Bakersfield,CA 93308—661.327.4911—Fax:661.327.1918—www.bclabs-com <br />