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11Received by: 11Relinquished by: 11Received by: 11Relinquished by: / 11Received by: 11Relinquished by: I/ Signature I''' 5.1 .. 7 <br />6 , IlSampler Printed: 14, - A e->c 5.1" eto 11Sampler Signature: A, I Report Attention: In_ C ç -FIE IIProject# / PO# / 7 . 451- Phone/Email: Ps2SV P C242 IICity/State/ZIP: c4 e-t IlAddrees: t o /Y1 (e 5 61/1-o 6: Rio Wistomer P 6 4.1 • <br />,,, <br />-... <br />**P. `PP,. •-e...- <br />....N.,., <br />‘\ <br />... <br />••••,1 <br />3 ... <br />k SAMPLE ID - <br />V <br />'6C'pi 1 <br />N <br />\s/ DATE <br />‘.N <br />1"\ m <br />....' <br />444.. <br />X Printed Name , <br />0 <br />>2.- <br />- <br />-C DESCRIPTION/LOCATION <br />SAMPLE TYPE <br />composi e(c) discrete/grab(d) <br />- <br />LI 1•1 N Date SAMPLE MATRIX <br />soil(s) liquid@ vapor(v) other (o) <br />BTEYJMTBE/TPH-GAS 8021/8015 REQUESTED ANALYSES 1 <br />--, v ....... - --I TPH-DIESEL / MOTOR OIL - 80150 <br />TRPH 418.1M / SM5520C & F <br />.4....‘,\,7...:1, Company Name I <br />Oxy's / EDB / DCA by 8260 <br />8260 Volatile s- full list <br />PCBs - 8082 <br />Electronic Deliverables (EDF) Turn Around Time: 24 Hour 48 Hour 3 Day I I 5 Day (Normal) >ZC Special:_ - . NUMBER OF CONTAINERS Total number of containers submitted to the laboratory I OBSERVATIONS/REMARKS 11 Notes: c1(, 1.1 Method of Shipment: