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CIM <br /> ff Phone: (800) 519-9300 <br /> I AdvancedC <br /> Fax: (888) 445-8786 <br /> An Employee-Owned Company DATE: 3 PAGE of i <br /> Analysis Required <br /> M <br /> Project Manager: <br /> Project Name: Email: <br /> 5A-u 104eq <br /> « 11�J CcrvnJt' Gpy -ti/ 12N1�4Y� L� DV', C�Gt�� & - <br /> Client: Sa r: <� ti <br /> AddresslLocation: Lab Project No.: <br /> tirlT� <br /> liflo <br /> ,�Ow N 1�_ <br /> Sample ID/Location/Description Al Date Time Matrix # Notes <br /> t11 ,r- 3 2 /BIZ r� <br /> j <br /> r <br /> Relinquished b bate: Time: Laboratory' +� <br /> z3 2 <br /> Courier: Receive by' Date: Time: <br /> , Ir) A A vi, Z I Z�� <br /> Relinquished by: Date: Time: Recei'ed y: Date: Time: <br /> z 3 z 23 <br /> Relinquished by: D te: Time: Received by: Da e. Time: <br /> Requested Turn Around Time: 24 hours 48 hours 72 hours 5 da Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: Global ID: Auth d Signature: <br /> V ` <br /> i <br /> i <br /> Page 27 of 28 <br />