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• q6- 510 <br /> North State Environmental Analytical Laboratory Chain of Custody/Request for Analysis <br /> Phone: (415) 588-9652 Fax: (415) 588-1950 Lab Job No.: Page _ of <br /> Client: epz ,Ic Report to: 5�/'(�!✓ 5j42 Phone: 707 4 t 2Jy Turnaround Time <br /> Mailing Address: Billing to: Fax: Z14hI2- <br /> 2j0�O 7-64%6011 RI-) ' (2 �C u G. PO#/Billing Reference: Date: 3 a9 [i u k <br /> V ACA V I C L. 6f `, t' Sampler: C✓1 <br /> Project/Site Address: Analysis c <br /> Zg Z 7 yam ''., oJll<P GAr�w <br /> Requested 9e_ <br /> Sample ID Sample Container Pres. Sampling �W Comments/Hazard <br /> Type No./Type Date/Time l) <br /> l —4 <br /> — 1Vk2-10' So;L l 54 3 26 fib' le! � <br /> ld'9I �1 Sot'c � &L — 3 lazj o <br /> 3 5 - <br /> 1014V Z Soc L 1 59 10361� X <br /> SPI — S bci� I fX_ — z9/� r 1041 <br /> Ir(,p5- 5P1 -A/ )04q <br /> / ro Co 0 <br /> /d A"Iaj <br /> Relinquished by: 01,9L Date:3� qq Time:a;oo pr Received by: rlSc S Lab Comments <br /> Relinquished by: Date: Time: Received by: <br /> Relinquished by: Date: Time: Received by: <br />