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IPL MPLETE <br /> it> oratories, Inc. Chain of C tody Form BE oTEID E <br /> _ <br /> IA <br /> eport To — <br /> Client Pro ect# Woo/ C, 247 y ` ' 46016 Page- <br /> Protect <br /> age of <br /> ttn <br /> Pro ect Name z1,eZ 4 /. s Comments: <br /> IF <br /> Street Address fn Project Code V/9 Z e r t ha .k I t) f <br /> City,State Zip- Sampler(s)' r 01 1p -tic' 1 <br /> Phone q Fax 9�rs 4 -,Oil/__ llt t� id Ill Lh4 d <br /> 12 } Sample Matnx Are there anv tests with holding times less than <br /> Email Address / 4 8-0 � . or equal to 48 hours' <br /> y � Y �� <br /> Submittal# �� :�,. � � 3 = ° a,° ❑ Yes ❑ No <br /> +tion `ate „ 3 E *Standard Turnaround= 15 work days <br /> Sample. DescriTime <br /> Notes <br /> Sampled Sampled c°voC.'C73 Other � <br /> od Iz4 a FT 5- � VMS L'i L46 t <br /> w - 1/2 6 <br /> kx Y I I I r� tc,•l �` <br /> 113 ' 31,,t 14 <br /> IN <br /> Same as above Report Drinking <br /> Sample Disposal Special Reporting <br /> Waters on State Form' ❑ Return to Client ❑ Disposal by lab ❑ Archive Months------—__ ❑ QC ❑ WIP ❑ Raw Data <br /> Client -� ° �`�' ❑Yes ❑ NO 1 R Date Time 1 By Date Ttme <br /> Address — ——— 1 4�A.4 <br /> Send Copy to State of 2 Re q hed Date Time 2 k�Luv <br /> d Dat Time <br /> City State Zip cap l <br /> 6 <br /> Attn ❑Yes ❑NO 3 e t q s e y` Time 3 rued By Date Time <br /> Po# � 47 <br /> - a <br /> BC Laboratories,Inc -4100 Atlas 0 -Bakersfield, CA 93 8- 327 4911-F 6 13 71918-www bclabs coin <br />