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PanLabs (Environmental Chemistry Analysis) <br /> 32 0Avenue 10 - Madera, California 93638 ADivisionoj —..�di�d�� . <br /> (209) 675-0889 (800) 846-0008 • FAX (209) 675-0884 Laboratories,Inc. <br /> 7200 E.ABC Lane,Commblr,MO 65202 <br /> Tct: 3141474-8574 Fwc 314!443-9033 <br /> CHAIN-OF-CUSTODY FORM ( - " <br /> RUS11 JOB 7CIISTOMFR INFORMATION RF PORT INFORMATION RLiQUESTED ANALYSES <br /> t <br /> ABC1Pan-Ag Lacy lob a: Customer Name: /7-?.*. r v S�,, 0_ 'gr „ Report Attention: Z J, -TA • a ° N <br /> address: 0 3 f � / �., � Project,P.O.#: x1 S-/ <br /> Lime Entered on LI NIS: City,State,Zip: .rf s.q .'Project Name:Sg ti fR X 4 <br /> 'hone: �a`j r _ „ r Project Manager: _ in d <br /> w <br /> Iax Copy To: <br /> Lab Sample I.P.* Date Time Sampler: Sample Type U <br /> l9ail,Liquid No.of <br /> Sampled Sampled Client Sample Description Local ion/De th o-o... Containers V <br /> -75 <br /> �/ <br /> -6 <br /> Gr X x <br /> 7! "o : 1f 5- G r--I X x <br /> 7d— S'7 uv X <br /> 7 ©:a/s S- - - m P.z <br /> D R/ <br /> l'urnaround,rime: Comments: ARE SAMPLES: PRFSERVAT[VE: <br /> Standard Turnaround Ao 2��8 h/t/� TOXIC? NaOH <br /> (10 toning apys) AJ, FLAMMABLE? H2SO4 <br /> (1 Pi 1,L1Ai'J'Sjmpks-5Days) EXPLOSIVE? HNO3 <br /> T� Rush 5 Day HIGHLEVELS7 HCI <br /> Rush 3 Day ASCORBICACID <br /> Rush Day FOR CAM METALS: <br /> Rush 1 Day D STLC TTLC <br /> Signature Date Time <br /> am — <br /> Printed Name t Companyany N <br /> ame <br /> cd By •Rclinyuish _ pm 74 7, �o 4, <br /> A-MCd By ! i— 3-'5ympm " 41_ j v CA <br /> (Winyui,hcd By: am pm <br /> Iteceivcd By: am pm <br /> Itc4eivcd for LaburaioryBy: <br /> PLEASE?CALL THE NUMBERS LISTED ABOVE FOR COMMENTS,QUESTIONS,AND QUOTATIONS, THANK YOU FOR YOUR CONTINUED PATRONAGE. <br />