Laserfiche WebLink
www.fglinc.com tom CHAIN OF CUSTODY <br /> ww. <br /> fg AND ANALYSIS REQUEST DOCUMENT <br /> Client: 5-G AG Manaoement Lab Number: TEST DESCRIPTION AND ANALYSES REQUESTED <br /> Customer Number: 3017380 2132 l 2 <br /> Address: P.O. Box 476 <br /> AcamDo.CA 95220 <br /> Phone: (209)8104606 Fax: m <br /> Email Address: leitfamilV aC).att.net gg <br /> Contact Person: 3 Son Elliott <br /> Project Name sly//v�/u Male., v <br /> Purchase Order N ber:J <br /> Quote Number: (UU"L7 <br /> Rush Analysis: E] 5 Day❑4 Day F]3 Day❑2 Day❑24 hour e ss O <br /> - <br /> Rush pre-approval by lab(inhale): 2 <br /> Electronic Data Transfer: EINo[:]State []Client Other: o <br /> Sampler(s): mm <br /> 13 <br /> Sampling Fee: Pickup Fee: a <br /> Compositor Setup Date: Time <br /> Same Location Description Date Time <br /> Ntmn Sampled Sampled <br /> IMQ,t 2-I i 21 i 0';>'O b P o X <br /> 1CA, 103,0 X <br /> etnarks Relinquished Date: Time: Relinquished Date: Time: Reln urshed Date: Time: <br /> bK- <br /> Receiv By: Date: Time: Retied By: Date: Time: Received By: Date: Time: <br /> 13, 2 cws— 2 '� i zl 1124 2 �i 2( I1 Iois <br /> Corporate Office&Laboratory Office d Laboratory Office&LaborOffice atory Oce b Laboratory Moe 3 Laboratory <br /> 853 Corporation Street 2500 Stagecoach Road 583 E.Lando Avenue 3442 Empresa Drive,Suite 0 9415 W.Goshen Avenue <br /> Santa Paula,CA 93080 Stockton,CA 95215 Chico,CA 95928 Sen Luis Obispo,CA 93401 Visalia,CA 93291 <br /> TEL:(805)392-2000 TEL:(209)942-0182 TEL(530)343-5818 TEL:(805)783-2940 TEL:(559)734-9473 <br /> Env FAX:(805)525-4172/Ag FAX:(805)392-2063 FAX--(209)942-0423 FAX:(530)343-N07 FAX:(805)783-2912 FAX:(559)734-8435 <br /> CA ELAP Certification No.1573 CA ELAP Certification No,1563 CA EIRP Certification No.2670 CA FLAP Certification No.2775 CA ELAP Certification No.2810 <br />