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� • i <br /> CASTLE ANALYTICAL LABORATORYy CHAIN OF CUSTODY <br /> Location 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 Certificate Wo 2079 <br /> Mailing Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE l OF_ ` <br /> Phone (209) 364-2930 - Fax (209) 384-1507 <br /> Customer R &' rvJ C f REQUESTFO ANALYSES _ Method of Shipment <br /> Address 93- <br /> + S} o <br /> City/State/ZIP t w <br /> a, ° v� Z Notes <br /> Phone / FAX �i �� ( o Lu <br /> Prot # / PQ # � � � owe LU a m Q a O <br /> Report Attention `T,r► a a a a <br /> -' fL <br /> E ° F <br /> Sampler Signature n 8 m m <br /> Printed <br /> C N Z <br /> Lob 1t}# SAMPLE ID DATE TIME DESCRIPTION/LOCATION r' OSS ERVATIONS/REMARKS <br /> MOW 6 MIXd I 'aLl <br /> ' - <br /> "1006clikmn-)) 16()� <br /> 83008 <br /> Mie l 7- <br /> v M C r �u 83009 <br /> ! k , 3101 _ 83010 <br /> CLWID I Raw �- <br /> 83011 <br /> 83012 <br /> 83013 <br /> 83014 <br /> HrAf <br /> z - � <br /> 83015 <br /> IT-otalnumb <br /> Sig ure Printed !Name pqte I�Time ComponY Name the laboratory <br /> Relinquished by 1( 4' Note All special requests(e g quick <br /> ( ! tum times)must be cleared through <br /> Received by �! d1 authorized laboratory personnel <br /> Relinquished by <br /> Received by <br /> Relinquished by RESULTS DUE <br /> Received by L3 VERBAL 1NRiTTEN <br />