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CA E ANALYTICAL LABORATORY CHAIN OF CUS Y <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No 2079 <br /> Marling Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE OF <br /> Phone (209) 384-2930 - Fax (209) 3B4-1507 <br /> Customer f�' ' {� DI REQUESTED ANALYSES Method of Shipment <br /> Address. - / s d L�' 1 1 <br /> City/State/ZIP. !r C5 w <br /> Phone 1 FAX ,�C[ �-� G _ �'a a `� a a Notes C 0010V �E' <br /> ` ul _ a w ym S�p1�ec1 ' � <br /> PrD) # / PQ # } j am urs m w O <br /> q O [3 <br /> Report Attention a t1 a 0. 0 <br /> Sampler Signature ^ am ~ ~ m 08353 <br /> Printed .; <br /> a <br /> Z 08354 <br /> Lab Ib* SAMPLE!D DATE TIME UESCRIPTIONILOCATION � <br /> 08355 <br /> J �1k�9 <br /> 08355 <br /> 08357 <br /> -� - 08358 <br /> 08359 <br /> w- 08360 <br /> 1 08361 <br /> Total number of oonta,ners submitted to <br /> tura Printed Name Date Time Company Name I the laboratory <br /> Relinquished by A A Note All special requests(e g quick <br /> Receivedtum R u f turn times)must be cleared through <br /> Rehnqurshe y authorized laboratory personnel <br /> Received by VQAS I Q&G3 I MEFALS OTHER <br /> Relinquished by <br /> RESULTS DUE <br /> Received by VERBAL WRITTEN <br />