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. � SPLInc. s1'I worttarderlVo - 03 597 <br /> ® Anal sis Re uest & Cham of Custody Record ���Z <br /> Qicnc Name ,,I L 1 matrix bottle size pres. Requested Analysis <br /> f! N <br /> AddrtwThonc <br /> CW � <br /> f r� V 4j N M <br /> n� i <br /> CLent Contact `'I r�-�• r rJ/l 1 pc.,�j.1, , � V � a y O � U <br /> Project Name w �,.w=-( <br /> Proftct Ntutnber f > N Q U <br /> Profen Location s ill l A Q <br /> N L +� t <br /> Ir+voce To Fv s -'i s r.'y N3 II °a - oxo x .i 1 <br /> 1 .a f I, II If 11 II <br /> SAMPLE ID IlAT TIMI; camp gab � to L. t' — an -� t►; � _ <br /> r <br /> l <br /> 10)+L_ f e G V > <br /> Sb x <br /> � w - y J <br /> M ' 3 lyV �/ o <br /> i <br /> i <br /> I � <br /> chenvconsuitant Rrmarks Laborato rctnarks <br /> 'y Intactp Y Q N ? <br /> Tem <br /> Requested TAT .Special Repofung Rcquucments Fa,Resclts Ll Raw Dau C) ISpccW Dctecuon iutut,(speuiy) PM rcvtcw(initial) <br /> Standard QC Level 3 QC Le%el 4 QC Q <br /> ca <br /> 2 Or Q 72hr Q 1 Rawgwshed by SarePl r date tune 2 Rcoe:ved by, <br /> 48}if Standard W 3 Relu4quulte+d ^ URr 4 K[CIMCd <br /> CD <br /> 011ier S Relutquuhed by date runt 6 Raocived by Laboratory <br /> ❑ 6880 Interchange Dave, Houston,TX 77034 (713) 660-0901 500 Ambassador Caffery Parkway.Scott, LA 70583 (319) 237-4775 , I <br /> rn <br /> 459 Hughes Drive,Traverse City, MI 49684 (616) 947-5777 1511 h Orangethorpe Avenue,Fullerton.CA 92631 (714) 447-6868 <br />