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CLS - Labs. CHAIN OF CUSTODY CLS ID No.; SZ>_ LOG NO. 12638 <br /> REPORT TO: CLIENT JOBIA <br /> NUMBER ANALYSIS REQUESTED FIELD CONDITIONS: , <br /> NAME AND ADDRESS IQ1rZr�.. .�Z4t r 5rVAf 41001ejy <br /> DESTINATION LABORATORY <br /> /f'7$EZT/e.✓ CIl IS .o <br /> V <br /> I CLS (916) 638-7301 M �y <br /> PROJECT MANAGER PHONE 3,/ RANCHO 3249 FITZGERALD RD. m COMPOSITE: <br /> CORDOVA,CA. (n <br /> 95742 m <br /> PROJECTNAME (Y� <br /> �A/sx Soa /Ll9xXEr ❑ OTHER <br /> SAMPLED BY <br /> JOB DESCRIPTION r L <br /> MX Q TURN AROUND TIME SPECIAL INSTRUCTIONS <br /> SITE LOCATION <br /> U o <br /> SAMPLE CONTAINER <br /> DATE TIME -IDENTIFICATION MATRIX NO. TYPE <br /> s2� GT less- �srn/o r 4 vo 3 <br /> f410 CSMto � /n {/©A v _ - <br /> 1/OA <br /> v: <br /> �µi$' CSM /oa-SS- SoOML <br /> �yyo CSrti 10?- S:7- VD.4 3 'f <br /> Isco Csn�1 to96 doa 3 f J ✓ /Pt/S <br /> INVOICE TO: <br /> P.O.# <br /> QUOTE Y <br /> SUSPECTED CONSTITUENTS SAMPLE RETENTION TIME PRESERVATIVES: (1)HCL (3)=COLD <br /> (2)HCL IS) <br /> RELINQUISHED BY(SIGN) PRINT NAME/COMPANY DATE/TIME RECEIVED BY(SIGN) PRINT NAME <br /> �/�iCOMPANY <br /> / [ S/23 <br /> c <br /> �r <br /> CD AT LAB BY. ., DpTB/TIME: CONDITIONS/COMMENTS: <br /> S�LIf //lea <br /> SHIPPED BY: ❑ UPS OTHER AIR BILL# ; <br />