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! � � � ! ! � ! ! � _ 11♦ lilltillt� <br /> VOSITIVE <br /> CHAIN OF CUSTODY AN <br /> 781 East Washington Btvd, � ANALYSIS REQUEST <br /> Los Angeles,CA 90021 ��j�/ DATE "10-0 PA 1 r <br /> IMPF LAB SERVICE (213)745-5312 FAX(213)745-6372 LOG BOOK NO FILE NO —.—LAB NO <br /> CLIENT NAME OtJ ANALYSES REQUESTED AIRBILL NO: <br /> COOLER TEMP3np-- <br /> PROJECT NAMESTD Lk TO IJ PROJECT NO S- P 0 NO <br /> PRESERVED. <br /> ADDRESS "3 y Sp Q„s ST 5-C Zk z- C� c_3 f'o$aCc OC REPORT <br /> LEVEL <br /> PROJECT MANAGER , '"�p� PHONE NO 98-S- 2.-1!&S FAX NO -7 S9 J <br /> SAMPLER NAME �Q 12L4 M MD"-b I REMARKS <br /> IPnnledl �� <br /> TAT(Analytical Turn Around Time) 0 a Same Day, 1 a 24 Hour, 2=48 Hour, (Etc) =NORMAL <br /> 1 � <br /> CONTAINER TYPES B-Brass,G-Glass,P=Plastic,'�l Vial,0=Other -O <br /> SAMPLE DATE TIME MATRIX CONTAINER N SAMPLE CONDITION/ <br /> NO SAMPLED SAMPLED SAMPLE DESCRIPTION WATER SOIL SLUDGE OTHER TAT ; rvvE to COMMENTS. <br /> i <br /> Mv3�3 q m l l4-0 <br /> Mw-z 14/� 1303 -A y- <br /> Mv►1-� Cv/ap <br /> � X <br /> I n <br /> ,ell ui ey/Signature and Pnn mal R ewed By I Printed Name) _ le SAMPLE DISPOSITION <br /> r vV (,� U 1 Samples returned to client? YES NO <br /> nqus {Sign a and nrd <br /> C+ Data Time <br /> R 2 Samples will not be stored over 30 days unless <br /> ` additional storage time is requested <br /> Date l <br /> RdfiMuis By IS�gname and Prrrded Namel ec Red By l5valure and nn Time <br /> 3 Storage time requested days <br /> SPECIAL INSTRUCTIONS By Date <br />