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� Vs <br /> �7 <br /> OCIATED LABORATORIES <br /> sob N Batavia• Orange, CA 9286a - C CHAT IV OF CUSTQD CORD <br /> (714) 771-6940• FAX (714) 538-1209 <br /> Date Page l of <br /> CLIENT kT-N)%A) I i <br /> PROJECT MANAGER V <br /> ADDRESS HC-tr r ZO Samples Intact Yes !� No <br /> vZ '� 'f~'� County Seals Intact Yes No e� <br /> Dl�ut n7� ��� '2} PHONEMSZL/V Sample Ambient_ Cooled-XFrozen_ <br /> PROJECT NAME SAM ERS {Signature) Same Day 24 Hr <br /> CACni taA)-S s f tOt� C Regular 48 Hr <br /> SAMPLE LOCATION DATE r+ME SAMPLE TYPE NO OF SUSP TESTS <br /> NUMBER DESCRIPTION WATER A+R SOLID CNTNRS CONTAM REQUIRED <br /> S HOMO - I C1 <br /> i <br /> el+ u ed by {Sig a Rec Date/Time I hereby authorize the performance of the above <br /> indicated work <br /> el nqu+s ece+ oratory for analysis Date/Time <br /> (Signature) <br /> ?J <br /> a � <br /> pec+ W6ns <br /> DIST IBU ON/rIV +te with report Yellow to AL, <br /> P+6k o Courier <br /> r <br />